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Association of Gas Diffusing Capacity of the Lung for Carbon Monoxide with Cardiovascular Morbidity and Survival in a Disadvantaged Clinical Population

PURPOSE: Low diffusing capacity of the lung for carbon monoxide (D(LCO)) and spirometry values are associated with increased mortality risk. However, associations between mortality risk and cardiovascular disease with the transfer coefficient of the lung for carbon monoxide (K(CO)) and alveolar volu...

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Autores principales: Collaro, Andrew J., Chang, Anne B., Marchant, Julie M., Chatfield, Mark D., Dent, Annette, Fong, Kwun M., McElrea, Margaret S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9589745/
https://www.ncbi.nlm.nih.gov/pubmed/36273051
http://dx.doi.org/10.1007/s00408-022-00580-9
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author Collaro, Andrew J.
Chang, Anne B.
Marchant, Julie M.
Chatfield, Mark D.
Dent, Annette
Fong, Kwun M.
McElrea, Margaret S.
author_facet Collaro, Andrew J.
Chang, Anne B.
Marchant, Julie M.
Chatfield, Mark D.
Dent, Annette
Fong, Kwun M.
McElrea, Margaret S.
author_sort Collaro, Andrew J.
collection PubMed
description PURPOSE: Low diffusing capacity of the lung for carbon monoxide (D(LCO)) and spirometry values are associated with increased mortality risk. However, associations between mortality risk and cardiovascular disease with the transfer coefficient of the lung for carbon monoxide (K(CO)) and alveolar volume (V(A)) are unknown. This cohort study: (i) evaluated whether D(LCO), K(CO), and V(A) abnormalities are independently associated with cardiovascular morbidity and/or elevated mortality risk and, (ii) compared these associations with those using spirometry values. METHODS: Gas-diffusing capacity and spirometry data of 1165 adults seen at specialist respiratory outreach clinics over an 8-year period (241 with cardiovascular disease; 108 deceased) were analysed using multivariable Cox and logistic regression. RESULTS: D(LCO), K(CO), and V(A) values below the lower limit of normal (< − 1.64 Z-scores) were associated with elevated cardiovascular disease prevalence [respective odds ratios of 1.83 (95% CI 1.31–2.55), 1.56 (95% CI 1.08–2.25), 2.20 (95% CI 1.60–3.01)] and increased all-cause mortality risk [respective hazard ratios of 2.99 (95% CI 1.83–4.90), 2.14 (95% CI 1.38–3.32), 2.75 (95% CI 1.18–2.58)], after adjustment for factors including age, personal smoking, and respiratory disease. Compared to similar levels of spirometry abnormality, D(LCO), K(CO), and V(A) were associated with similar or greater mortality risk, and similar cardiovascular disease prevalence. Analysis of only those patients with clinical normal spirometry values (n = 544) showed these associations persisted for D(LCO). CONCLUSION: Low D(LCO), K(CO), and V(A) measurements are associated with cardiovascular disease prevalence. As risk factors of all-cause mortality, they are more sensitive than spirometry even among patients with no diagnosed respiratory disease.
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spelling pubmed-95897452022-10-24 Association of Gas Diffusing Capacity of the Lung for Carbon Monoxide with Cardiovascular Morbidity and Survival in a Disadvantaged Clinical Population Collaro, Andrew J. Chang, Anne B. Marchant, Julie M. Chatfield, Mark D. Dent, Annette Fong, Kwun M. McElrea, Margaret S. Lung Pulmonary Function and Mortality PURPOSE: Low diffusing capacity of the lung for carbon monoxide (D(LCO)) and spirometry values are associated with increased mortality risk. However, associations between mortality risk and cardiovascular disease with the transfer coefficient of the lung for carbon monoxide (K(CO)) and alveolar volume (V(A)) are unknown. This cohort study: (i) evaluated whether D(LCO), K(CO), and V(A) abnormalities are independently associated with cardiovascular morbidity and/or elevated mortality risk and, (ii) compared these associations with those using spirometry values. METHODS: Gas-diffusing capacity and spirometry data of 1165 adults seen at specialist respiratory outreach clinics over an 8-year period (241 with cardiovascular disease; 108 deceased) were analysed using multivariable Cox and logistic regression. RESULTS: D(LCO), K(CO), and V(A) values below the lower limit of normal (< − 1.64 Z-scores) were associated with elevated cardiovascular disease prevalence [respective odds ratios of 1.83 (95% CI 1.31–2.55), 1.56 (95% CI 1.08–2.25), 2.20 (95% CI 1.60–3.01)] and increased all-cause mortality risk [respective hazard ratios of 2.99 (95% CI 1.83–4.90), 2.14 (95% CI 1.38–3.32), 2.75 (95% CI 1.18–2.58)], after adjustment for factors including age, personal smoking, and respiratory disease. Compared to similar levels of spirometry abnormality, D(LCO), K(CO), and V(A) were associated with similar or greater mortality risk, and similar cardiovascular disease prevalence. Analysis of only those patients with clinical normal spirometry values (n = 544) showed these associations persisted for D(LCO). CONCLUSION: Low D(LCO), K(CO), and V(A) measurements are associated with cardiovascular disease prevalence. As risk factors of all-cause mortality, they are more sensitive than spirometry even among patients with no diagnosed respiratory disease. Springer US 2022-10-22 2022 /pmc/articles/PMC9589745/ /pubmed/36273051 http://dx.doi.org/10.1007/s00408-022-00580-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Pulmonary Function and Mortality
Collaro, Andrew J.
Chang, Anne B.
Marchant, Julie M.
Chatfield, Mark D.
Dent, Annette
Fong, Kwun M.
McElrea, Margaret S.
Association of Gas Diffusing Capacity of the Lung for Carbon Monoxide with Cardiovascular Morbidity and Survival in a Disadvantaged Clinical Population
title Association of Gas Diffusing Capacity of the Lung for Carbon Monoxide with Cardiovascular Morbidity and Survival in a Disadvantaged Clinical Population
title_full Association of Gas Diffusing Capacity of the Lung for Carbon Monoxide with Cardiovascular Morbidity and Survival in a Disadvantaged Clinical Population
title_fullStr Association of Gas Diffusing Capacity of the Lung for Carbon Monoxide with Cardiovascular Morbidity and Survival in a Disadvantaged Clinical Population
title_full_unstemmed Association of Gas Diffusing Capacity of the Lung for Carbon Monoxide with Cardiovascular Morbidity and Survival in a Disadvantaged Clinical Population
title_short Association of Gas Diffusing Capacity of the Lung for Carbon Monoxide with Cardiovascular Morbidity and Survival in a Disadvantaged Clinical Population
title_sort association of gas diffusing capacity of the lung for carbon monoxide with cardiovascular morbidity and survival in a disadvantaged clinical population
topic Pulmonary Function and Mortality
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9589745/
https://www.ncbi.nlm.nih.gov/pubmed/36273051
http://dx.doi.org/10.1007/s00408-022-00580-9
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