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Lung Function Decline and Disease Risk from Young Adulthood to Middle Age

The major goals of this grant are to evaluate factors in young adults that predict incident COPD and/or restriction, to determine whether incident COPD and incident restriction are associated with distinct cardiac structural and functional changes, and to determine the lung structural and intrathoracic vascular changes associated with incident COPD and incident restriction.

Ravi Kalhan

Dr. Ravi Kalhan

Professor of Medicine (Pulmonary and Critical Care), Northwestern University
Professor of Preventive Medicine (Epidemiology), Northwestern University

Ravi Kalhan, MD, MS is Deputy Division Chief of Pulmonary and Critical Care Medicine at Northwestern. He additionally serves as co-director of the Center...

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Sadiya Khan

Dr. Sadiya S Khan

Assistant Professor of Medicine (Cardiology), Northwestern University
Assistant Professor of Preventive Medicine (Epidemiology), Northwestern University
Dr. Khan is board certified in Internal Medicine and Cardiovascular Diseases and holds active medical licensure in the state of Illinois. She received her... Read more about Sadiya S Khan
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NMH/Arkes Family Pavilion Suite 600
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Chicago Illinois 60611
Raul San Jose

Dr. Raúl San José Estépar

Co-Director, Applied Chest Imaging Laboratory
Lead Investigator, Brigham and Women's Hospital
Associate Professor of Radiology, Harvard Medical School
Raúl is co-director of the Applied Chest Imaging Laboratory, lead scientist at Brigham and Women's Hospital and Associate Professor of Radiology at Harvard Medical School. With a background in Telecommunications Engineering from the University of Valladolid in Spain, Raúl has dedicated his career to advancing medical imaging techniques and applications.
 
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Kalhan R, Cuttica MJ, Colangelo LA, Shah SJ, Lima J, Kishi S, Arynchyn A, Jacobs DR, Thyagarajan B, Liu K, Lloyd-Jones D. Loss of Lung Health from Young Adulthood and Cardiac Phenotypes in Middle Age. Am J Respir Crit Care Med 2015;192(1):76-85.Abstract

RATIONALE: Chronic lung diseases are associated with cardiovascular disease. How these associations evolve from young adulthood forward is unknown. Understanding the preclinical history of these associations could inform prevention strategies for common heart-lung conditions. OBJECTIVES: To use the Coronary Artery Risk Development in Young Adults (CARDIA) study to explore the development of heart-lung interactions. METHODS: We analyzed cardiac structural and functional measurements determined by echocardiography at Year 25 of CARDIA and measures of pulmonary function over 20 years in 3,000 participants. MEASUREMENTS AND MAIN RESULTS: Decline in FVC from peak was associated with larger left ventricular mass (β = 6.05 g per SD of FVC decline; P < 0.0001) and greater cardiac output (β = 0.109 L/min per SD of FVC decline; P = 0.001). Decline in FEV1/FVC ratio was associated with smaller left atrial internal dimension (β = -0.038 cm per SD FEV1/FVC decline; P < 0.0001) and lower cardiac output (β = -0.070 L/min per SD of FEV1/FVC decline; P = 0.03). Decline in FVC was associated with diastolic dysfunction (odds ratio, 3.39; 95% confidence interval, 1.37-8.36; P = 0.006). CONCLUSIONS: Patterns of loss of lung health are associated with specific cardiovascular phenotypes in middle age. Decline in FEV1/FVC ratio is associated with underfilling of the left heart and low cardiac output. Decline in FVC with preserved FEV1/FVC ratio is associated with left ventricular hypertrophy and diastolic dysfunction. Cardiopulmonary interactions apparent with common complex heart and lung diseases evolve concurrently from early adulthood forward.