Impairment of Pulmonary Function is an Independent Risk Factor for Atrial Fibrillation: The Takahata Study

Abstract

Background: Chronic pulmonary disorders, such as chronic obstructive pulmonary disease (COPD) and fibrosing lung diseases, and atrial fibrillation (AF), are prevalent in elderly people. The impact of cardiac co-morbidities in the elderly, where pulmonary function is impaired, cannot be ignored as they influence mortality. The relationship between the prevalence of AF and pulmonary function is unclear. The aim of this study was to evaluate this relationship in participants in a health check. Methods: Subjects aged 40 or older (n = 2,917) who participated in a community-based annual health check in Takahata, Japan, from 2004 through to 2005, were enrolled in the study. We performed blood pressure measurements, blood sampling, electrocardiograms, and spirometry on these subjects. Results: The mean FEV 1 % predicted and FVC % predicted in AF subjects was significantly lower than in non-AF subjects. The prevalence of AF was higher in those subjects with airflow limitation or lung restriction than in those without. Furthermore, AF prevalence was higher in those subjects with severe airflow obstruction (FEV 1 %predicted < 50) than in those who had mild or moderate airflow obstruction (FEV 1 %predicted ≥ 50), although there was no difference between the prevalence of AF in subjects with 70≤ FVC %predicted <80 lung restriction and those with FVC %predicted <70. Multiple logistic regression analysis revealed that FEV 1 %predicted and FVC %predicted are independent risk factors for AF (independent of age, gender, left ventricular hypertrophy, and serum levels of B-type natriuretic peptide). Conclusion: Impaired pulmonary function is an independent risk factor for AF in the Japanese general population.

Relationship between Plasma Fibrinogen Levels and Pulmonary Function in the Japanese Population: The Takahata Study

“…This study was part of the Molecular Epidemiological Study of the Regional Characteristics of 21st Century Centers of Excellence (COE) Program and the Global Centers of Excellence Program in Japan 13-19. The Ethics Committee of Yamagata University School of Medicine approved the study, the study was conducted in accordance with the Declaration of Helsinki and all the participants gave written informed consent prior to enrollment.…”

Cardiopulmonary factors associated with atrial fibrillation in patients with chronic obstructive pulmonary disease

“…), что приводит к развитию сер-дечно-сосудистых заболеваний (АГ, ИБС, ХСН) и по-вышению риска сердечно-сосудистых событий в этой группе пациентов. При обсуждении механизмов влия-ния ХОБЛ на возникновение аритмий в литературе, как правило, описываются характеристики правых камер сердца, аритмогенные эффекты терапии [3,4,[7][8][9]. В на-шем исследовании выявлены ранее описанные в ли-тературе взаимосвязи морфо-функциональных пара-метров правых камер сердца с характеристиками тече-ния ХОБЛ.…”

“…Негативное влияние на сердечно-сосудистую систему таких меха-низмов, как системное воспаление, оксидативный стресс, эндотелиальная дисфункция, гипоксия у боль-ных ХОБЛ приводит к развитию артериальной гипер-тензии (АГ), ишемической болезни сердца (ИБС), хронической сердечной недостаточности (ХСН), арит-мий. По некоторым данным фибрилляция предсердий (ФП) чаще встречается среди больных ХОБЛ, чем в об-щей популяции, и связана с тяжестью бронхообструк-ции и проаритмогенными эффектами ингаляционной терапии ХОБЛ [3,4]. Наличие ФП у больных ХОБЛ не-гативно влияет на исходы, учитывая высокий риск тромбоэмболических осложнений и ремоделирование сердца с развитием сердечной недостаточности [5,6].…”

Cardiac manifestations of idiopathic pulmonary fibrosis

“…The postulated mechanisms for arrhythmias in these patients include the presence of hypoxia, elevation of pulmonary pressures, the risk of coronary artery disease and the presence chronic inflammation (19,21). Hypoxia results in increased sympathetic activity thereby increasing the risk for arrhythmias.…”

“…The side effect profile of Pirfenidone mainly included gastrointestinal side effects but no cardiac side effects were reported (30) and the same results were found in the CAPACITY trial, which was performed in 113 surgery difficult, increased age and the increased risk of coronary artery disease in patients with IPF. Shibata et al studied patients with IPF and COPD over 5 years to assess the causal relationship between pulmonary function tests and the development of AF (19). They reported that both decrease in FEV% (forced expiratory volume) (OR, 0.982; CI, 0.965 to 0.999; p < 0.05) and FVC% (functional vital capacity) (OR, 0.977; CI, 0.956 to 0.998; p < 0.05) were independent risk factors for development of AF.…”