Use of vital capacity for cardiac failure risk estimation in persons with coronary disease and left ventricular hypertrophy

Cardiac failure is a common lethal outcome of coronary heart disease and left ventricular hypertrophy. The efficacy of forced vital capacity (FVC), measured biennially, in predicting the onset of cardiac failure was explored in 818 Framingham Study subjects with these predisposing conditions, among whom 324 developed cardiac failure. Among the men and women who had coronary disease or left ventricular hypertrophy, those with FVCs in the lowest quartile were at substantially increased risk of developing cardiac failure. For men, comparing the lowest quartile with men whose FVCs were in the highest quartile (<2.7 L vs >5.6 L), the risk ratio was 1.8; for women with FVCs <1.7 L, the risk was 2.3 times those with FVCs of ≥3.5 L. The excess risk of cardiac failure imposed by a low FVC was similar in those with coronary disease and left ventricular hypertrophy. The simple FVC is an inexpensive and robust predictor of cardiac failure in persons predisposed by coronary disease or left ventricular hypertrophy. FVC determination should help identify candidates for cardiac failure needing echocardiographic examination for ventricular dysfunction.