To understand how lung disease and cardiovascular disease evolve together, Northwestern Medicine scientists analyzed lung and cardiac measurements from 3,000 people followed from young adulthood through middle age. They identified two heart-lung phenotypes that may form the basis for diseases that develop later in life.
The study, published in the American Journal of Respiratory and Critical Care Medicine, may help inform more targeted therapies to prevent common lung diseases from manifesting.
“Surprisingly, little is known about how and why lung disease develops in people as we age and how that is linked to cardiovascular outcomes. This is in contrast to the field of cardiology, where the last 50 years have been spent identifying and modifying risk factors like high blood pressure and high cholesterol to prevent heart disease,” said first author Michael Cuttica, ’01 MD, ’04 ’06 GME, assistant professor in Medicine-Pulmonary. “This study addresses an area of pulmonary medicine that needs to be better explored in order to develop strategies to prevent lung disease.”
The investigators used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, which began tracking a large cohort of generally healthy individuals aged 18 to 30 in 1985. Throughout 25 years, CARDIA participants underwent exams that included spirometry tests to measure lung function and echocardiograms to visualize the heart. Dr. Cuttica and colleagues examined how decreases in lung health between young adulthood and middle age connected to changes in the heart.
They discovered two phenotypes: A pattern of declining lung function over time that indicated participants might develop chronic obstructive pulmonary disease (such as emphysema or chronic bronchitis) was associated with smaller hearts and lower cardiac output than normal. Lung function decline that suggested participants might develop restrictive lung disease (smaller lungs) had thicker heart muscle, higher cardiac output and diastolic dysfunction.
[pullquote]“It’s a set-up for groundbreaking clinical research in the field of pulmonary medicine,” said Dr. Cuttica.[/pullquote]
“It’s exciting to have the ability to follow people from young adulthood as they reach peak lung function through to midlife as the loss of lung health is beginning to translate into the onset of lung disease,” Dr. Cuttica said. “It’s a set-up for groundbreaking clinical research in the field of pulmonary medicine.”
With senior author Ravi Kalhan, MD, ’06 GME, associate professor in Medicine-Pulmonary and Preventive Medicine, Dr. Cuttica plans to continue to learn from the CARDIA data as its population continues to age and their diseases progress.
CARDIA is supported by contracts HHSN268201300025C, HHSN268201300026C, HHSN268201300027C, HHSN268201300028C, HHSN268201300029C and HHSN268200900041C from the National Heart, Lung, and Blood Institute (NHLBI); the Intramural Research Program of the National Institute on Aging (NIA); and an intra-agency agreement between NIA and NHLBI (AG0005). Additional support for this project came from NHLBI grant R01 HL122477.
