Pulmonary function and diffusion capacity are associated with pulmonary arterial systolic pressure in the general population: The Rotterdam Study

• Published in: Respiratory medicine Vol. 132; pp. 50 - 55
• Main Authors: Loth, Daan W., Lahousse, Lies, Leening, Maarten J.G., Krijthe, Bouwe P., Felix, Janine F., Gall, Henning, Hofman, Albert, Ghofrani, H. Ardeschir, Franco, Oscar H., Stricker, Bruno H., Brusselle, Guy G.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2017; Elsevier Limited
• Subjects: Air flow; Blood pressure; Chronic obstructive pulmonary disease; Diffusion capacity; Echocardiography; Guidelines; Heart; Hypertension; Lung diseases; Lung function; Population studies; Pulmonary artery systolic pressure; Pulmonary functions; Pulmonary hypertension; Respiratory function; Right ventricular failure; Systolic pressure; Ventricle; Diffusion capacity; Pulmonary artery systolic pressure; Lung function; Echocardiography; Pulmonary hypertension
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2017.09.009

Pulmonary hypertension is a progressive heterogeneous syndrome, characterized by elevated pulmonary arterial pressure which can lead to right ventricular failure. Although the presence of elevated pulmonary arterial systolic pressure (PASP) in patients with a lung disease is a well-known occurrence, little is known about the association between pulmonary function and PASP in the general population. We hypothesized that pulmonary function and PASP are associated, irrespective of airflow limitation. This study was performed within the Rotterdam Study, a prospective population-based cohort. We included 1660 participants with spirometry, performed and interpreted according to ATS/ERS-guidelines, and echocardiography performed according to the ASE/EAE/CSE-guidelines. We analyzed the association of Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity (FVC), FEV1/FVC and diffusion capacity (DLCO) with estimated PASP (ePASP). Furthermore, we investigated the association between spirometry measures, COPD, and echocardiographic pulmonary hypertension. A 10% absolute decrease in FEV1 was associated with an ePASP increase of 0.46 mmHg (95%CI: 0.31; 0.61). Similarly, per absolute 10% decrease, FVC was significantly associated with an increased ePASP of 0.42 mmHg (95%CI: 0.25; 0.59). FEV1/FVC showed an association of 1.01 mmHg (95%CI: 0.58; 1.45) increase in ePASP per 10% absolute decrease. A decrease in DLCO (in mL/min/kPa) was associated with an increased ePASP (0.46 mmHg, 95%CI: 0.17; 0.76). We found significant associations for FEV1 and FVC with echocardiographic pulmonary hypertension. Importantly, an increased ePASP was significantly associated with mortality (Hazard Ratio: 1.042 per mmHg [95%CI: 1.023–1.062; p < 0.001]). We observed a clearly graded association between pulmonary function and ePASP and pulmonary hypertension, even in individuals without airflow limitation. •Pulmonary artery systolic pressure is associated with spirometry in the general population.•Pulmonary artery pressure is associated with diffusion capacity.•This association remains irrespective of the presence of airflow obstruction.•Effect sizes are small, but provide insight in pulmonary artery pressure in an aging population.