AIMS:Reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) have been associated with increased incidence of cardiovascular diseases. However, whether reduced lung function is also a risk factor for incidence of atrial fibrillation (AF) is still unclear. We aimed to determine whether lung function predicted AF in the Malmö Preventive Project, a large population-based cohort with a long follow-up. METHODS AND RESULTS:The study population consisted of 7674 women and 21 070 men, mean age 44.6 years. The cohort was followed on average for 24.8 years, during which time 2669 patients were hospitalized due to AF. The incidence of AF in relationship to quartiles of FEV1 and FVC and per litre decrease at baseline was determined using a Cox proportional hazards model adjusted for age, height, weight, current smoking status, systolic blood pressure, erythrocyte sedimentation rate, and fasting blood glucose. Forced expiratory volume in one second was inversely related to incidence of AF (per litre reduction in FEV1) hazard ratio (HR): 1.39 [95% confidence interval (CI): 1.16-1.68; P = 0.001] for women, and HR: 1.20 (95% CI: 1.13-1.29; P < 0.0001) for men. Forced vital capacity was also inversely related to incidence of AF (per litre reduction in FVC) HR: 1.20 (95% CI: 1.03-1.41; P = 0.020) for women, and HR: 1.08 (95% CI: 1.02-1.14; P = 0.01) for men. This relationship was consistent in non-smokers as well as smokers, and among individuals younger than the median age of 45.8 years or normotensive subjects. CONCLUSION:Impaired lung function is an independent predictor of AF. This may explain some risk of AF that is currently unaccounted for.

译文

目的:一秒钟内减少强制呼气量(FEV1)和强制肺活量(FVC)与心血管疾病的发病率增加相关。但是,肺功能下降是否也是心房颤动(AF)发生的危险因素仍不清楚。我们旨在确定在马尔默预防项目中,肺功能是否能预测房颤,该项目是一项以人群为基础的大型队列研究,需要长期随访。
方法与结果:研究人群为7674名女性和21 070名男性,平均年龄44.6岁。该队列平均随访了24.8年,在此期间有2669例因AF住院的患者。使用针对年龄,身高,体重,当前吸烟状况,收缩压,红细胞沉降率和空腹血糖调整的Cox比例风险模型,确定与FEV1和FVC四分位数相关的房颤发生率以及基线时每升的下降。一秒钟的强制呼气量与房颤的发生率(每升FEV1减少)成反比(HR):1.39 [95%置信区间(CI):1.16-1.68; P = 0.001](女性)和HR:1.20(95%CI:1.13-1.29; P <0.0001)。强迫肺活量也与AF的发生率成反比(女性每升FVC降低)HR:女性HR:1.20(95%CI:1.03-1.41; P = 0.020); HR:1.08(95%CI:1.02-1.14); P = 0.01)。在非吸烟者和吸烟者中,以及年龄中位数为45.8岁以下或血压正常的受试者之间,这种关系是一致的。
结论:肺功能受损是房颤的独立预测因子。这可以解释目前尚无法解决的房颤风险。

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