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. 2022 Aug 4;60(2):2101821.
doi: 10.1183/13993003.01821-2021. Print 2022 Aug.

The association of lung function and pulmonary vasculature volume with cardiorespiratory fitness in the community

Jenna McNeill  1   2 , Ariel Chernofsky  3   4   2 , Matthew Nayor  5 , Farbod N Rahaghi  6 , Raul San Jose Estepar  7 , George Washko  6 , Andrew Synn  8 , Ramachandran S Vasan  9 , George O'Connor  9 , Martin G Larson  3   4 , Jennifer E Ho  10   2 , Gregory D Lewis  5   2
Affiliations

The association of lung function and pulmonary vasculature volume with cardiorespiratory fitness in the community

Jenna McNeill et al. Eur Respir J. .

Abstract

Background: Cardiorespiratory fitness is not limited by pulmonary mechanical reasons in the majority of adults. However, the degree to which lung function contributes to exercise response patterns among ostensibly healthy individuals remains unclear.

Methods: We examined 2314 Framingham Heart Study participants who underwent cardiopulmonary exercise testing (CPET) and pulmonary function testing. We investigated the association of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC and diffusing capacity of the lung for carbon monoxide (D LCO) with the primary outcome of peak oxygen uptake (V'O2 ) along with other CPET parameters using multivariable linear regression. Finally, we investigated the association of total and peripheral pulmonary blood vessel volume with peak V'O2 .

Results: We found lower FEV1, FVC and D LCO were associated with lower peak V'O2 . For example, a 1 L lower FEV1 and FVC was associated with a 7.1% (95% CI 5.1-9.1%) and 6.0% (95% CI 4.3-7.7%) lower peak V'O2 , respectively. By contrast, FEV1/FVC was not associated with peak V'O2 . Lower lung function was associated with lower oxygen uptake efficiency slope, oxygen pulse slope, V'O2 at anaerobic threshold (AT), minute ventilation (V'E) at AT and breathing reserve. In addition, lower total and peripheral pulmonary blood vessel volume were associated with lower peak V'O2 .

Conclusions: In a large, community-based cohort of adults, we found lower FEV1, FVC and D LCO were associated with lower exercise capacity, as well as oxygen uptake efficiency slope and ventilatory efficiency. In addition, lower total and peripheral pulmonary blood vessel volume were associated with lower peak V'O2 . These findings underscore the importance of lung function and blood vessel volume as contributors to overall exercise capacity.

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Conflict of interest statement

Conflict of interest: J. McNeill has nothing to disclose. Conflict of interest: A. Chernofsky has nothing to disclose. Conflict of interest: M. Nayor reports grants from the NIH, during the conduct of the study. Conflict of interest: F.N. Rahaghi has nothing to disclose. Conflict of interest: R. San Jose Estepar has contracts with Lung Biotechnology, Insmed and Boehringer Ingelheim, receives consulting fees from Leuko Labs, and has stock options in Quantitative Imaging Solutions. Conflict of interest: G. Washko reports grants from the NIH, DoD, Boehringer Ingelheim, Janssen Pharmaceuticals, BTG Therapeutics, Pulmonx, Lung Biotechnology and Insmed; participation in advisory boards and consultancies for Boehringer Ingelheim, CSL Behring, Novartis, Phillips and Vertex Pharmaceuticals; is a co-founder and equity shareholder in Quantitative Imaging Solutions, a company that provides consulting services for image and data analytics; finally, the author's spouse works for Biogen. Conflict of interest: A. Synn reports grants from the American Lung Association and NHLBI, outside the submitted work. Conflict of interest: R.S. Vasan has nothing to disclose. Conflict of interest: G. O'Connor has nothing to disclose. Conflict of interest: M.G. Larson has nothing to disclose. Conflict of interest: J.E. Ho reports grants from the NIH/NHLBI, during the conduct of the study; research support from Gilead Sciences and Bayer AG, and research supplies from EcoNugenics, outside the submitted work. Conflict of interest: G.D. Lewis reports grants from Amgen, Cytokinetics, AstraZeneca, Applied Therapeutics and Sonivie, personal fees and other for advisory board work from American Regent, outside the submitted work.

Figures

Figure 1.
Figure 1.. Peak VO2 across quartiles of lung function measurements.
Forest plots displaying the peak VO2least squares means adjusted for age, sex, height and weight across quartiles of FEV1, FVC, FEV1/FVC, and DLCO. The black points represent the quartile mean peak VO2.
Figure 2:
Figure 2:. Unadjusted associations of lung function measurements with peak oxygen consumption.
Scatter plots displaying the relationship of peak VO2 within FEV1 (Panel A), FVC (Panel B), FEV1/FVC (Panel C), and DLCO (Panel D). An unadjusted linear fit to the datapoints is included with a 95% confidence bands. Histograms of each variable are included on the margins. Raw data display of A. FEV1, B. FVC, C. FEV1/FVC D. DLCO with relative peak VO2 with the dots representing individual participants
Figure 3.
Figure 3.. Peak VO2 across quartiles of CT pulmonary vasculature volumes.
Forest plots displaying the peak VO2 least squares means adjusted for age, sex, height and weight across quartiles of BV5, TBV, BV5/TBV, and BV5/total lung volume. The black points represent the quartile mean peak VO2.
See this image and copyright information in PMC

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