The association of lung function and pulmonary vasculature volume with cardiorespiratory fitness in the community,European Respiratory Journal

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The association of lung function and pulmonary vasculature volume with cardiorespiratory fitness in the community
European Respiratory Journal ( IF 16.6 ) Pub Date : 2022-08-04 , DOI: 10.1183/13993003.01821-2021
Jenna McNeill _{1,

2} , Ariel Chernofsky _{2,

3,

4} , Matthew Nayor ₅ , Farbod N Rahaghi ₆ , Raul San Jose Estepar ₇ , George Washko ₆ , Andrew Synn ₈ , Ramachandran S Vasan ₉ , George O'Connor ₉ , Martin G Larson _{3,

4} , Jennifer E Ho _{2,

10} , Gregory D Lewis _{2,

5}

Affiliation

Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
These four authors are co-authors.
Boston University and National Heart, Lung, and Blood Institute Framingham Heart Study, Framingham, MA, USA.
Biostatistics Dept, Boston University School of Public Health, Boston, MA, USA.
Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Division of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Framingham Heart Study and Sections of Preventive Medicine and Epidemiology and Cardiovascular Medicine, Boston University School of Medicine, and Dept of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA

Background

Cardiorespiratory fitness is not limited by pulmonary mechanical reasons in the majority of adults. However, the degree to which lung function contributes to exercise response patterns among ostensibly healthy individuals remains unclear.

Methods

We examined 2314 Framingham Heart Study participants who underwent cardiopulmonary exercise testing (CPET) and pulmonary function testing. We investigated the association of forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), FEV₁/FVC and diffusing capacity of the lung for carbon monoxide (D_LCO) with the primary outcome of peak oxygen uptake (V'_O₂) along with other CPET parameters using multivariable linear regression. Finally, we investigated the association of total and peripheral pulmonary blood vessel volume with peak V'_O₂.

Results

We found lower FEV₁, FVC and D_LCO were associated with lower peak V'_O₂. For example, a 1 L lower FEV₁ and FVC was associated with a 7.1% (95% CI 5.1–9.1%) and 6.0% (95% CI 4.3–7.7%) lower peak V'_O₂, respectively. By contrast, FEV₁/FVC was not associated with peak V'_O₂. Lower lung function was associated with lower oxygen uptake efficiency slope, oxygen pulse slope, V'_O₂ at anaerobic threshold (AT), minute ventilation (V'_E) at AT and breathing reserve. In addition, lower total and peripheral pulmonary blood vessel volume were associated with lower peak V'_O₂.

Conclusions

In a large, community-based cohort of adults, we found lower FEV₁, FVC and D_LCO were associated with lower exercise capacity, as well as oxygen uptake efficiency slope and ventilatory efficiency. In addition, lower total and peripheral pulmonary blood vessel volume were associated with lower peak V'_O₂. These findings underscore the importance of lung function and blood vessel volume as contributors to overall exercise capacity.

中文翻译：

社区肺功能和肺血管容量与心肺健康的关系

背景

大多数成年人的心肺健康不受肺部机械原因的限制。然而，肺功能对表面健康个体运动反应模式的影响程度仍不清楚。

方法

我们检查了 2314 名弗雷明汉心脏研究参与者，他们接受了心肺运动测试 (CPET) 和肺功能测试。我们研究了 1 秒用力呼气量 (FEV ₁ )、用力肺活量 (FVC)、FEV ₁ /FVC 和肺一氧化碳弥散能力 ( D _LCO ) 与峰值摄氧量 ( V ' _{O ₂} ) 以及使用多元线性回归的其他 CPET 参数。最后，我们研究了总肺血管容量和外周肺血管容量与峰值V'O _₂的关系。

结果

我们发现较低的 FEV ₁ 、FVC 和D _LCO与较低的V'O _₂峰值相关。例如，FEV ₁和 FVC 降低 1 L 分别与峰值V ' _{O ₂}降低 7.1% (95% CI 5.1–9.1%) 和 6.0% (95% CI 4.3–7.7%) 相关。相比之下，FEV ₁ /FVC 与峰值V'O _₂无关。较低的肺功能与较低的摄氧效率斜率、氧脉冲斜率、无氧阈值（AT）下的V'O _₂ 、AT下的每分钟通气量（ V'E _）和呼吸储备有关。此外，较低的总肺血管容积和外周肺血管容积与较低的V'O _₂峰值相关。