TY - JOUR
T1 - Independent prognostic value of pulmonary diffusing capacity in nonsmoking patients with chronic heart failure
AU - Nakamura, Kenji
AU - Kanzaki, Hideaki
AU - Okada, Atsushi
AU - Amaki, Makoto
AU - Takahama, Hiroyuki
AU - Hasegawa, Takuya
AU - Sugano, Yasuo
AU - Yasuda, Satoshi
AU - Anzai, Toshihisa
N1 - Funding Information:
From the 1Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan. This study was supported by Intramural Research Fund (28-2-4) for Cardiovascular Diseases of National Cerebral and Cardiovascular Center. Address for correspondence: Hideaki Kanzaki, MD, Department of Cardiovascular Medicine, Heart Failure Division, National Cerebral and Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka 565-8565, Japan. E-mail: kanzakih@ncvc.go.jp Received for publication July 10, 2018. Revised and accepted September 21, 2018. Released in advance online on J-STAGE February 22, 2019. doi: 10.1536/ihj.18-420 All rights reserved by the International Heart Journal Association.
Publisher Copyright:
© 2019, International Heart Journal Association. All rights reserved.
PY - 2019
Y1 - 2019
N2 - The diffusing capacity of the lung for carbon monoxide (DLCO) is indicative of the alveolar-capillary membrane function. A reduced DLCO is associated with poor prognosis in chronic heart failure (HF). However, the significance of DLCO as an independent prognostic predictor has not been established. Here, we aimed to determine the prognostic value of DLCO in patients with chronic HF. We enrolled 214 patients (139 females, mean age: 63 ± 16 years, left ventricular ejection fraction [LVEF]: 45 ± 21%) with stable chronic HF who underwent pulmonary function tests. Only never smokers were included in the analysis because smoking can decrease DLCO. During a median follow-up period of 2.1 years, 52 patients (24.3%) experienced cardiac events, including unplanned HF admissions, left ventricular assist device (LVAD) implantations, all-cause deaths, and cardiopulmonary arrests (CPAs). The median percent predicted DLCO (%DLCO) was 87.3%. In a Cox regression analysis, a %DLCO of ≤87.3% was independently associated with the cardiac events, even after adjusting for age, sex, systolic blood pressure (SBP), LVEF, anemia, brain natriuretic peptide, estimated glomerular filtration rate (eGFR), and prior HF admission (hazard ratio [HR]: 1.87, 95% confidence interval: 1.03-3.53, P = 0.030). A reduced DLCO is an independent predictor of poor prognosis in nonsmoking patients with chronic HF.
AB - The diffusing capacity of the lung for carbon monoxide (DLCO) is indicative of the alveolar-capillary membrane function. A reduced DLCO is associated with poor prognosis in chronic heart failure (HF). However, the significance of DLCO as an independent prognostic predictor has not been established. Here, we aimed to determine the prognostic value of DLCO in patients with chronic HF. We enrolled 214 patients (139 females, mean age: 63 ± 16 years, left ventricular ejection fraction [LVEF]: 45 ± 21%) with stable chronic HF who underwent pulmonary function tests. Only never smokers were included in the analysis because smoking can decrease DLCO. During a median follow-up period of 2.1 years, 52 patients (24.3%) experienced cardiac events, including unplanned HF admissions, left ventricular assist device (LVAD) implantations, all-cause deaths, and cardiopulmonary arrests (CPAs). The median percent predicted DLCO (%DLCO) was 87.3%. In a Cox regression analysis, a %DLCO of ≤87.3% was independently associated with the cardiac events, even after adjusting for age, sex, systolic blood pressure (SBP), LVEF, anemia, brain natriuretic peptide, estimated glomerular filtration rate (eGFR), and prior HF admission (hazard ratio [HR]: 1.87, 95% confidence interval: 1.03-3.53, P = 0.030). A reduced DLCO is an independent predictor of poor prognosis in nonsmoking patients with chronic HF.
KW - DLCO
KW - Pulmonary function
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U2 - 10.1536/IHJ.18-420
DO - 10.1536/IHJ.18-420
M3 - Article
C2 - 30799383
AN - SCOPUS:85063251476
VL - 60
SP - 366
EP - 373
JO - International Heart Journal
JF - International Heart Journal
SN - 1349-2365
IS - 2
ER -