Variation in lung function and alterations in cardiac structure and function—Analysis of the UK Biobank cardiovascular magnetic resonance imaging substudy

Ross J. Thomson; Nay Aung; Mihir M. Sanghvi; Jose Miguel Paiva; Aaron M. Lee; Filip Zemrak; Kenneth Fung; Paul E. Pfeffer; Alexander J. Mackay; Tricia M. McKeever; Elena Lukaschuk; Valentina Carapella; Young Jin Kim; Charlotte E. Bolton; Stefan K. Piechnik; Stefan Neubauer; Steffen E. Petersen

doi:10.1371/journal.pone.0194434

Variation in lung function and alterations in cardiac structure and function—Analysis of the UK Biobank cardiovascular magnetic resonance imaging substudy

Ross J. Thomson, Nay Aung, Mihir M. Sanghvi, Jose Miguel Paiva, Aaron M. Lee, Filip Zemrak, Kenneth Fung, Paul E. Pfeffer, Alexander J. Mackay, Tricia M. McKeever, Elena Lukaschuk, Valentina Carapella, Young Jin Kim, Charlotte E. Bolton, Stefan K. Piechnik, Stefan Neubauer, Steffen E. Petersen

Department of Radiology

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Background Reduced lung function is common and associated with increased cardiovascular morbidity and mortality, even in asymptomatic individuals without diagnosed respiratory disease. Previous studies have identified relationships between lung function and cardiovascular structure in individuals with pulmonary disease, but the relationships in those free from diagnosed cardiorespiratory disease have not been fully explored. Methods UK Biobank is a prospective cohort study of community participants in the United Kingdom. Individuals self-reported demographics and co-morbidities, and a subset underwent cardiovascular magnetic resonance (CMR) imaging and spirometry. CMR images were analysed to derive ventricular volumes and mass. The relationships between CMR-derived measures and spirometry and age were modelled with multivariable linear regression, taking account of the effects of possible confounders. Results Data were available for 4,975 individuals, and after exclusion of those with pre-existing cardiorespiratory disease and unacceptable spirometry, 1,406 were included in the analyses. In fully-adjusted multivariable linear models lower FEV₁ and FVC were associated with smaller left ventricular end-diastolic (−5.21ml per standard deviation (SD) change in FEV₁, −5.69ml per SD change in FVC), end-systolic (−2.34ml, −2.56ml) and stroke volumes (−2.85ml, −3.11ml); right ventricular end-diastolic (−5.62ml, −5.84ml), end-systolic (−2.47ml, −2.46ml) and stroke volumes (−3.13ml, −3.36ml); and with lower left ventricular mass (−2.29g, −2.46g). Changes of comparable magnitude and direction were observed per decade increase in age. Conclusions This study shows that reduced FEV₁ and FVC are associated with smaller ventricular volumes and reduced ventricular mass. The changes seen per standard deviation change in FEV₁ and FVC are comparable to one decade of ageing.

Original language	English
Article number	e0194434
Journal	PloS one
Volume	13
Issue number	3
DOIs	https://doi.org/10.1371/journal.pone.0194434
Publication status	Published - 2018 Mar

Bibliographical note

Funding Information:
SEP, SN and SKP acknowledge the British Heart Foundation for funding the manual analysis to create a cardiovascular magnetic resonance imaging reference standard for the UK Biobank imaging resource in 5000 CMR scans (www.bhf.org.uk; PG/14/89/31194). SEP acts as a paid consultant to Circle Cardiovascular Imaging Inc., Calgary, Canada. NA is supported by a Wellcome Trust Research Training Fellowship (wellcome.ac.uk; 203553/Z/Z). KF is supported by the Medical College of Saint Bartholomew’s Hospital Trust (www.bartscharity.org.uk). AL and SEP acknowledge support from the National Institute for Health Research (NIHR) Cardiovascular Biomedical Research Centre at Barts and from the “SmartHeart” EPSRC programme grant (www.nihr.ac.uk; EP/P001009/ 1). SN and SKP are supported by the Oxford NIHR Biomedical Research Centre and the Oxford British Heart Foundation Centre of Research Excellence. TMM and CEB are supported by the NIHR Nottingham Biomedical Research Centre. This project was enabled through access to the MRC eMedLab Medical Bioinformatics infrastructure, supported by the Medical Research Council (www. mrc.ac.uk; MR/L016311/1). The funders provided support in the form of salaries for authors as detailed above, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of the authors are articulated in the ‘author contributions’ section.

Publisher Copyright:
© 2018 Thomson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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10.1371/journal.pone.0194434

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Thomson, R. J., Aung, N., Sanghvi, M. M., Paiva, J. M., Lee, A. M., Zemrak, F., Fung, K., Pfeffer, P. E., Mackay, A. J., McKeever, T. M., Lukaschuk, E., Carapella, V., Kim, Y. J., Bolton, C. E., Piechnik, S. K., Neubauer, S., & Petersen, S. E. (2018). Variation in lung function and alterations in cardiac structure and function—Analysis of the UK Biobank cardiovascular magnetic resonance imaging substudy. PloS one, 13(3), [e0194434]. https://doi.org/10.1371/journal.pone.0194434

@article{3ca3d58c23b440eaab8f454149203fb0,

title = "Variation in lung function and alterations in cardiac structure and function—Analysis of the UK Biobank cardiovascular magnetic resonance imaging substudy",

abstract = "Background Reduced lung function is common and associated with increased cardiovascular morbidity and mortality, even in asymptomatic individuals without diagnosed respiratory disease. Previous studies have identified relationships between lung function and cardiovascular structure in individuals with pulmonary disease, but the relationships in those free from diagnosed cardiorespiratory disease have not been fully explored. Methods UK Biobank is a prospective cohort study of community participants in the United Kingdom. Individuals self-reported demographics and co-morbidities, and a subset underwent cardiovascular magnetic resonance (CMR) imaging and spirometry. CMR images were analysed to derive ventricular volumes and mass. The relationships between CMR-derived measures and spirometry and age were modelled with multivariable linear regression, taking account of the effects of possible confounders. Results Data were available for 4,975 individuals, and after exclusion of those with pre-existing cardiorespiratory disease and unacceptable spirometry, 1,406 were included in the analyses. In fully-adjusted multivariable linear models lower FEV1 and FVC were associated with smaller left ventricular end-diastolic (−5.21ml per standard deviation (SD) change in FEV1, −5.69ml per SD change in FVC), end-systolic (−2.34ml, −2.56ml) and stroke volumes (−2.85ml, −3.11ml); right ventricular end-diastolic (−5.62ml, −5.84ml), end-systolic (−2.47ml, −2.46ml) and stroke volumes (−3.13ml, −3.36ml); and with lower left ventricular mass (−2.29g, −2.46g). Changes of comparable magnitude and direction were observed per decade increase in age. Conclusions This study shows that reduced FEV1 and FVC are associated with smaller ventricular volumes and reduced ventricular mass. The changes seen per standard deviation change in FEV1 and FVC are comparable to one decade of ageing.",

author = "Thomson, {Ross J.} and Nay Aung and Sanghvi, {Mihir M.} and Paiva, {Jose Miguel} and Lee, {Aaron M.} and Filip Zemrak and Kenneth Fung and Pfeffer, {Paul E.} and Mackay, {Alexander J.} and McKeever, {Tricia M.} and Elena Lukaschuk and Valentina Carapella and Kim, {Young Jin} and Bolton, {Charlotte E.} and Piechnik, {Stefan K.} and Stefan Neubauer and Petersen, {Steffen E.}",

note = "Funding Information: SEP, SN and SKP acknowledge the British Heart Foundation for funding the manual analysis to create a cardiovascular magnetic resonance imaging reference standard for the UK Biobank imaging resource in 5000 CMR scans (www.bhf.org.uk; PG/14/89/31194). SEP acts as a paid consultant to Circle Cardiovascular Imaging Inc., Calgary, Canada. NA is supported by a Wellcome Trust Research Training Fellowship (wellcome.ac.uk; 203553/Z/Z). KF is supported by the Medical College of Saint Bartholomew{\textquoteright}s Hospital Trust (www.bartscharity.org.uk). AL and SEP acknowledge support from the National Institute for Health Research (NIHR) Cardiovascular Biomedical Research Centre at Barts and from the “SmartHeart” EPSRC programme grant (www.nihr.ac.uk; EP/P001009/ 1). SN and SKP are supported by the Oxford NIHR Biomedical Research Centre and the Oxford British Heart Foundation Centre of Research Excellence. TMM and CEB are supported by the NIHR Nottingham Biomedical Research Centre. This project was enabled through access to the MRC eMedLab Medical Bioinformatics infrastructure, supported by the Medical Research Council (www. mrc.ac.uk; MR/L016311/1). The funders provided support in the form of salaries for authors as detailed above, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of the authors are articulated in the {\textquoteleft}author contributions{\textquoteright} section. Publisher Copyright: {\textcopyright} 2018 Thomson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2018",

month = mar,

doi = "10.1371/journal.pone.0194434",

language = "English",

volume = "13",

journal = "PLoS One",

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publisher = "Public Library of Science",

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Thomson, RJ, Aung, N, Sanghvi, MM, Paiva, JM, Lee, AM, Zemrak, F, Fung, K, Pfeffer, PE, Mackay, AJ, McKeever, TM, Lukaschuk, E, Carapella, V, Kim, YJ, Bolton, CE, Piechnik, SK, Neubauer, S & Petersen, SE 2018, 'Variation in lung function and alterations in cardiac structure and function—Analysis of the UK Biobank cardiovascular magnetic resonance imaging substudy', PloS one, vol. 13, no. 3, e0194434. https://doi.org/10.1371/journal.pone.0194434

TY - JOUR

T1 - Variation in lung function and alterations in cardiac structure and function—Analysis of the UK Biobank cardiovascular magnetic resonance imaging substudy

AU - Thomson, Ross J.

AU - Aung, Nay

AU - Sanghvi, Mihir M.

AU - Paiva, Jose Miguel

AU - Lee, Aaron M.

AU - Zemrak, Filip

AU - Fung, Kenneth

AU - Pfeffer, Paul E.

AU - Mackay, Alexander J.

AU - McKeever, Tricia M.

AU - Lukaschuk, Elena

AU - Carapella, Valentina

AU - Kim, Young Jin

AU - Bolton, Charlotte E.

AU - Piechnik, Stefan K.

AU - Neubauer, Stefan

AU - Petersen, Steffen E.

N1 - Funding Information: SEP, SN and SKP acknowledge the British Heart Foundation for funding the manual analysis to create a cardiovascular magnetic resonance imaging reference standard for the UK Biobank imaging resource in 5000 CMR scans (www.bhf.org.uk; PG/14/89/31194). SEP acts as a paid consultant to Circle Cardiovascular Imaging Inc., Calgary, Canada. NA is supported by a Wellcome Trust Research Training Fellowship (wellcome.ac.uk; 203553/Z/Z). KF is supported by the Medical College of Saint Bartholomew’s Hospital Trust (www.bartscharity.org.uk). AL and SEP acknowledge support from the National Institute for Health Research (NIHR) Cardiovascular Biomedical Research Centre at Barts and from the “SmartHeart” EPSRC programme grant (www.nihr.ac.uk; EP/P001009/ 1). SN and SKP are supported by the Oxford NIHR Biomedical Research Centre and the Oxford British Heart Foundation Centre of Research Excellence. TMM and CEB are supported by the NIHR Nottingham Biomedical Research Centre. This project was enabled through access to the MRC eMedLab Medical Bioinformatics infrastructure, supported by the Medical Research Council (www. mrc.ac.uk; MR/L016311/1). The funders provided support in the form of salaries for authors as detailed above, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of the authors are articulated in the ‘author contributions’ section. Publisher Copyright: © 2018 Thomson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2018/3

Y1 - 2018/3

N2 - Background Reduced lung function is common and associated with increased cardiovascular morbidity and mortality, even in asymptomatic individuals without diagnosed respiratory disease. Previous studies have identified relationships between lung function and cardiovascular structure in individuals with pulmonary disease, but the relationships in those free from diagnosed cardiorespiratory disease have not been fully explored. Methods UK Biobank is a prospective cohort study of community participants in the United Kingdom. Individuals self-reported demographics and co-morbidities, and a subset underwent cardiovascular magnetic resonance (CMR) imaging and spirometry. CMR images were analysed to derive ventricular volumes and mass. The relationships between CMR-derived measures and spirometry and age were modelled with multivariable linear regression, taking account of the effects of possible confounders. Results Data were available for 4,975 individuals, and after exclusion of those with pre-existing cardiorespiratory disease and unacceptable spirometry, 1,406 were included in the analyses. In fully-adjusted multivariable linear models lower FEV1 and FVC were associated with smaller left ventricular end-diastolic (−5.21ml per standard deviation (SD) change in FEV1, −5.69ml per SD change in FVC), end-systolic (−2.34ml, −2.56ml) and stroke volumes (−2.85ml, −3.11ml); right ventricular end-diastolic (−5.62ml, −5.84ml), end-systolic (−2.47ml, −2.46ml) and stroke volumes (−3.13ml, −3.36ml); and with lower left ventricular mass (−2.29g, −2.46g). Changes of comparable magnitude and direction were observed per decade increase in age. Conclusions This study shows that reduced FEV1 and FVC are associated with smaller ventricular volumes and reduced ventricular mass. The changes seen per standard deviation change in FEV1 and FVC are comparable to one decade of ageing.

AB - Background Reduced lung function is common and associated with increased cardiovascular morbidity and mortality, even in asymptomatic individuals without diagnosed respiratory disease. Previous studies have identified relationships between lung function and cardiovascular structure in individuals with pulmonary disease, but the relationships in those free from diagnosed cardiorespiratory disease have not been fully explored. Methods UK Biobank is a prospective cohort study of community participants in the United Kingdom. Individuals self-reported demographics and co-morbidities, and a subset underwent cardiovascular magnetic resonance (CMR) imaging and spirometry. CMR images were analysed to derive ventricular volumes and mass. The relationships between CMR-derived measures and spirometry and age were modelled with multivariable linear regression, taking account of the effects of possible confounders. Results Data were available for 4,975 individuals, and after exclusion of those with pre-existing cardiorespiratory disease and unacceptable spirometry, 1,406 were included in the analyses. In fully-adjusted multivariable linear models lower FEV1 and FVC were associated with smaller left ventricular end-diastolic (−5.21ml per standard deviation (SD) change in FEV1, −5.69ml per SD change in FVC), end-systolic (−2.34ml, −2.56ml) and stroke volumes (−2.85ml, −3.11ml); right ventricular end-diastolic (−5.62ml, −5.84ml), end-systolic (−2.47ml, −2.46ml) and stroke volumes (−3.13ml, −3.36ml); and with lower left ventricular mass (−2.29g, −2.46g). Changes of comparable magnitude and direction were observed per decade increase in age. Conclusions This study shows that reduced FEV1 and FVC are associated with smaller ventricular volumes and reduced ventricular mass. The changes seen per standard deviation change in FEV1 and FVC are comparable to one decade of ageing.

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Variation in lung function and alterations in cardiac structure and function—Analysis of the UK Biobank cardiovascular magnetic resonance imaging substudy

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