Using the Lower Limit of Normal Instead of the Conventional Cutoff Values to Define Predictors of Pulmonary Function Impairment in Subjects With Chronic Heart Failure.
BACKGROUND: Using the newer lower limit of normal criterion instead of the conventional cutoff values to define pulmonary function abnormalities may result in different predictors of pulmonary function impairment in patients with heart failure. Therefore, we assessed predictors of pulmonary function...
| Publicado en: | Respiratory Care Vol. 61; no. 2; pp. 173 - 184 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Feb2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=112667899&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 112667899 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Feb2016 vid: 61 iid: 2 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 112667899 112667899 112667899 10.4187/respcare.04101 112667899 ppf: 173 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Using the Lower Limit of Normal Instead of the Conventional Cutoff Values to Define Predictors of Pulmonary Function Impairment in Subjects With Chronic Heart Failure. aug: au: Minasian, Armine G. van den Elshout, Frank J. J. Dekhuijzen, Richard Vos, Petra J. E. Willems, Frank F. van den Bergh, Paul J. P. C. Heijdra, Yvonne F. affil: Department of Pulmonary Diseases, Rijnstate Hospital, Arnhem, The Netherlands sug: subj: Reference Values Respiratory Function Tests Heart Failure Complications Chronic Disease Lung Diseases Diagnosis Human Funding Source Aged Descriptive Statistics Middle Age Prospective Studies Cross Sectional Studies Ventricular Ejection Fraction Body Mass Index Forced Expiratory Volume Vital Capacity Inpatients Netherlands Radiography, Thoracic McNemar's Test T-Tests Chi Square Test Fisher's Exact Test Analysis of Variance Post Hoc Analysis Data Analysis Software Male Female Univariate Statistics Multivariate Analysis Logistic Regression Aged: 65+ years Middle Aged: 45-64 years Male Female ab: BACKGROUND: Using the newer lower limit of normal criterion instead of the conventional cutoff values to define pulmonary function abnormalities may result in different predictors of pulmonary function impairment in patients with heart failure. Therefore, we assessed predictors of pulmonary function impairment in subjects with chronic heart failure according to the lower limit of normal in comparison with conventional cutoff values. METHODS: In this prospective cross-sectional study, 164 chronic heart failure subjects (age 68 ± 10 y, 78% men, 88% New York Heart Association class I-II) with left ventricular ejection fraction <40% underwent pulmonary function tests. Predictors of pulmonary function impairment were assessed using the lower limit of normal and conventional cutoff values (ie, 80% predicted value and the fixed ratio of FEV1/FVC <0.7). RESULTS: The lower limit of normal criterion identified an extra independent predictor of diffusion impairment compared with the 80% predicted value; in addition to body mass index, pack-years, and alveolar volume, female sex also turned out to be an independent predictor. A smoking history of ≥ 10 pack-years was a significant predictor of diffusion impairment and airway obstruction using the lower limit of normal criterion but not using the conventional cutoff values. However, lowering the cutoff points of conventional criteria to match the more stringent lower limit of normal and thus avoid overdiagnosis of diffusion impairment and airway obstruction in the elderly produced similar results as the lower limit of normal. CONCLUSIONS: The lower limit of normal identifies more predictors of diffusion impairment and airway obstruction compared with conventional cutoff values in subjects with chronic heart failure with left ventricular systolic dysfunction. However, lowering the conventional cutoff points yielded similar results as the lower limit of normal. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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