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Emphysema Associated With Left Ventricular Issues

Percent emphysema, measured by CT, linked to reduced end-diastolic volumes, cardiac output

WEDNESDAY, Jan. 20 (HealthDay News) -- A greater extent of emphysema and more airflow obstruction is linked with poorer left ventricular filling and reduced cardiac output, according to research published in the Jan. 21 issue of the New England Journal of Medicine.

R. Graham Barr, M.D., of Columbia University in New York City, and colleagues analyzed data from 2,816 adults who were free of clinical cardiovascular disease; roughly half were never smokers. The extent of emphysema was assessed with computed tomography, and left ventricular structure and function were assessed with magnetic resonance imaging. Subjects also underwent spirometry.

The researchers found that a greater extent of emphysema, expressed as percent emphysema, was associated with reduced left ventricular end-diastolic volume, stroke volume, and cardiac output (respectively, −4.1 ml, −2.7 ml, and −0.19 liters per minute, per 10-point increase in percent emphysema). These findings were stronger among smokers than former smokers or lifelong nonsmokers. Extent of airflow obstruction was also associated with left ventricular structure and function. However, percent emphysema or airflow obstruction weren't associated with left ventricular ejection fraction.

"In conclusion, in this population-based study of subjects without very severe chronic obstructive pulmonary disease, percent emphysema and the severity of airflow obstruction were associated with significant decrements in left ventricular filling and cardiac output. The magnitude of these associations was greater among participants with a history of smoking," the authors write.

Several co-authors reported financial relationships with pharmaceutical companies.

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