Gender influences the relationship between lung function and cardiac remodeling in hypertensive subjects

Abstract

Hypertensive patients are predisposed to left ventricular (LV) remodeling and frequently exhibit decline in lung function as compared with the general population. Here, we investigated the association between spirometric and echocardiographic data in non-smoking hypertensive subjects and the role of gender in this regard. In a cross-sectional study, 107 hypertensive patients (60 women) enrolled from a university outpatient clinic were evaluated by clinical, hemodynamic, laboratory and echocardiographic analysis. Vital capacity, forced vital capacity (FVC), forced expired volume in 1 s (FEV1) and in 6 s (FEV6), FEV1/FVC ratio and FEV1/FEV6 ratio were estimated by spirometry. In women, higher LV mass index and E/Em ratio correlated with markers of restrictive lung alterations, such as reduced FVC (r=-044; P<0.001; r=-0.42; P<0.001, respectively) and FEV6 (r=-0.43; P<0.001; r=-0.39; P<0.01, respectively), while higher left atrial volume index correlated with markers of obstructive lung alterations, such as reduced FEV1/FVC (r=-055; P<0.001) and FEV1/FEV6 (r=-0.45; P<0.001) ratios. These relationships were further confirmed by stepwise regression analysis adjusted for potential confounders. In men, LV mass index correlated with FVC and FEV6, but these associations did not remain statistically significant after adjustment for confounding variables. Furthermore, inflammatory markers such as plasma C-reactive protein and matrix-metalloproteinases-2 and -9 levels did not influence the association between spirometric and cardiac parameters. In conclusion, these results indicate that LV remodeling is related to restrictive lung alterations while left atrial remodeling is associated with obstructive lung alterations in hypertensive women.

Low body mass is associated with reduced left ventricular mass in Chinese elderly with severe COPD

“…In addition, studies have confirmed that lower BMI may be related to increased cardiovascular events and cardiac mortality 9 , 10 . Although it is well known that long-term COPD will be complicated more often with lung functional impairment and pulmonary heart disease, which is characteristically manifested as right-sided atrial and ventricular enlargement, several studies have reported that reduced left-sided cardiac filling (preload) was found in COPD patients 11 , 12 , and the association of impaired lung function with left-sided cardiac atrial and ventricular dimensional changes was more often seen in hypertensive women 13 . However, up to now, it is unclear whether BMI is related to the left-sided cardiac structural remodeling corresponding to different severity of lung functional reduction in COPD patients.…”