{"id":"dbefaefd5346","type":"article","url":"https://hartvaat.nl/2026/05/05/wereldwijde-hf-registry-28-landen-fev1-is-een-onafhankelijke-prognostische-facto/","title":"Wereldwijde HF-registry (28 landen): FEV1 is een onafhankelijke prognostische factor — pleidooi voor spirometrie","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag128","source_url":"https://doi.org/10.1093/eschf/xvag128","authors":["MyLinh Duong","Shofiqul Islam","Philip Joseph","Darryl Leong","Alex Grinvalds","Tara McCready","Kelley R Branch","Andrzej Budaj","Albertino Damasceno","Juan Manuel Dominguez","Anastase Dzudie","Camilla Hage","Charles Mondo","Julius Chacha Mwita","Francesco Orso","Alexander Parkhomenko","Jeffrey Probstfield","Jean Rouleau","Sanjib Kumar Sharma","Jose Silva-Cardoso","Stefan Störk","Thomas Wittlinger","Gerald Yonga","Jun Zhu","Salim Yusuf"],"significance":7,"published":"2026-06-28","source_date":"2026-05-05","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/rechtsventrikelfalen/","https://hartvaat.nl/kennis/diagnostiek/cardiale-mri/"],"congress":"","summary_en":"Substudy within the Global Congestive Heart Failure registry, which collected clinical data and spirometry from 3,359 HF patients across 28 high-, middle-, and low-income countries (mean age 61.9 years, 66.4% male; median follow-up 3.8 years). Baseline FEV1 was converted to z-scores standardised for age, sex, and height. Lower FEV1 — even within the 'normal' range — was associated with greater HF burden, more cardiac structural/functional abnormalities, and lower quality of life. FEV1 z-score ≤-2 was independently associated with higher all-cause mortality (HR 2.20; 95% CI 1.61-3.01), CV mortality (HR 2.45), and all-cause hospitalisation (HR 1.40). The effect was comparable to other major HF prognostic factors and consistent across income levels, HF aetiology, HF type, and airflow obstruction. Spirometry therefore deserves a place in routine HF evaluation.","created":"2026-07-03T10:33:08Z","updated":"2026-07-03T13:32:02Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Substudie binnen het Global Congestive Heart Failure-register, dat klinische data en spirometrie verzamelde van 3.359 HF-patiënten uit 28 hoge-, midden- en lage-inkomenslanden (gemiddelde leeftijd 61,9 jaar, 66,4% mannen; mediane follow-up 3,8 jaar). Baseline-FEV1 werd omgezet in z-scores gestandaardiseerd voor leeftijd, geslacht en lengte. Lagere FEV1 — ook nog binnen het 'normale' bereik — was geassocieerd met hogere HF-last, meer cardiale structurele/functionele afwijkingen en lagere levenskwaliteit. FEV1 z-score ≤-2 was onafhankelijk geassocieerd met hogere totale sterfte (HR 2,20; 95%-BI 1,61-3,01), cardiovasculaire sterfte (HR 2,45) en alle-oorzaken opname (HR 1,40). Het effect was vergelijkbaar met andere belangrijke HF-prognostische factoren en consistent over inkomensniveaus, HF-etiologie, HF-type en aanwezigheid van obstructie. Spirometrie verdient daarmee een plaats in de standaard HF-evaluatie.","abstract_original":"AIMS: Pulmonary abnormalities are commonly reported in heart failure (HF) and may have prognostic implications. Current evidence is limited to high-income countries. We examined the relationship between forced expiratory volume in 1 second (FEV1), HF burden, and long-term clinical outcomes in a diverse multi-national HF cohort. METHODS AND RESULTS: In a sub-study within the multinational Global Congestive Heart Failure registry, which collected clinical data including spirometry from HF participants in 28 high-, middle-, and low-income countries, and followed for a median 3.8 (IQR 2.1, 5.0) years. Baseline FEV1 was transformed into z-scores standardized for age, sex, and height. The association between baseline FEV1 with all-cause mortality, cardiovascular (CV) deaths, and all-cause hospitalizations was examined. FINDINGS: The analysis included 3359 HF participants (mean age 61.9 [SD 14.1] years, 66.4% males). Participants with lower FEV1 z-scores, even within the normal range (z-score>-2), showed increasing burden of HF, cardiac structural and functional impairment, and lower health-related quality of life. FEV1 z-score ≤ -2 was independently associated with higher risks of all-cause (HR 2.20 [95%CI 1.61-3.01]), CV mortality (HR 2.45 [1.64-3.66]), and hospitalizations (HR 1.40 [1.12-1.74]). The effect sizes were comparable to those of other major prognostic factors. The association was consistent across populations from diverse socio-economic development, HF aetiology, HF types, and airflow obstruction. CONCLUSION: In a diverse, multi-national HF cohort, reductions in FEV1 were independently associated with higher HF burden and poor health outcomes. The effect of lower FEV1 was generalizable across the HF spectrum and comparable to other major established HF prognostic factors."}