Pulmonary Function is Associated with Distal Aortic Calcium, Not Proximal Aortic Distensibility. MESA Lung Study

Abstract

Forced expiratory volume in one second strongly predicts mortality from cardiovascular disease. FEV₁ has been associated with aortic stiffness a strong independent predictor of cardiovascular mortality. However, the anatomical site and possible mechanisms linking aortic stiffness and lung function are unknown. We therefore examined if FEV₁ and CT percent emphysema were associated with calcification of the abdominal aorta or reduced distensibility of the proximal thoracic aorta.The Multi-Ethnic Study of Atherosclerosis (MESA) measured aortic calcification on cardiac and abdominal CT scans and proximal aortic distensibility using magnetic resonance among participants aged 45–84 years without clinical cardiovascular disease. Spirometry was measured following ATS/ERS guidelines and percent emphysema was measured in the lung fields of cardiac CT scans. Multivariate analyses adjusted for age, sex, race/ethnicity and cardiovascular risk factors. Of 1,917 participants with aortic distensibility measures, 13% were current and 38% were former smokers. Eighteen percent had airflow limitation without asthma. FEV₁ was associated with the extent of distal aortic calcification (0.76; 95%CI 0.60–0.97, p = 0.02) but not proximal aortic calcification or proximal aortic distensibility (−0.04 mmHg⁻¹; 95%CI −0.16–0.09 mmHg⁻¹, p = 0.60). Percent emphysema was associated with neither measure. FEV₁ was associated with severity of distal aortic calcification where it was present independently of smoking and other cardiovascular risk factors but not with distensibility or calcification of the proximal aorta.

Keywords::

• Forced expiratory volume
• Pulmonary emphysema
• Aorta
• Calcification
• Compliance

ACKNOWLEDGMENTS

The MESA and MESA-Lung Studies are conducted and supported by the NHBLI (contracts N01-HC-95159 through N01-HC-95165 and N01-HC-95169 and grants R01 HL-077612 and R01 HL-075476) in collaboration with the MESA and MESA-Lung Investigators. This manuscript has been reviewed by the MESA Investigators for scientific content and consistency of data interpretation with previous MESA publications and significant comments have been incorporated prior to submission for publication. David McAllister is supported by a Fellowship Grant from Chest, Heart and Stroke Scotland. The authors thank the other investigators, staff, and participants of the MESA and MESA-Lung Studies for their valuable contributions. The authors wish to thank Dr Firas Ahmed for his help with coding. A full list of participating MESA Investigators and institutions can be found at http://www.mesa-nhlbi.org.