{"id":"dc11aae1bea5","type":"article","url":"https://hartvaat.nl/2026/05/13/wereldwijde-hf-registry-fev1-is-een-onafhankelijke-prognostische-factor-pleidooi/","title":"Wereldwijde HF-registry: FEV1 is een onafhankelijke prognostische factor — pleidooi voor routine-spirometrie bij hartfalen","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts","internist"],"tags":["acuut-hartfalen","heart-failure-2026","vrouwen"],"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","Global Congestive Heart Failure Registry Investigators"],"significance":7,"published":"2026-05-15","source_date":"2026-05-13","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/bnp-en-nt-probnp/","https://hartvaat.nl/kennis/hartfalen/palliatief-hartfalen/"],"congress":"heart-failure-2026","summary_en":"Global Congestive Heart Failure registry sub-study (n=3,359, 28 countries, median 3.8-y follow-up) finds FEV1 z-score ≤-2 is independently associated with all-cause mortality (HR 2.20), CV mortality (HR 2.45) and hospitalization (HR 1.40) — effect sizes comparable to other major HF prognostic factors. Even normal-range FEV1 reductions tracked with increased HF burden. Argues for routine spirometry as part of the HF workup across global populations.","created":"2026-07-03T10:32:56Z","updated":"2026-07-03T18:39:33Z","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":"Sub-studie binnen de Global Congestive Heart Failure registry, een prospectief register van 3.359 hartfalenpatiënten in 28 landen (hoog, middel en laag inkomen), mediaan 3,8 jaar follow-up. Baseline-FEV1 werd omgezet naar z-scores gestandaardiseerd voor leeftijd, geslacht en lengte. Een FEV1 z-score ≤-2 was onafhankelijk geassocieerd met: hogere all-cause mortaliteit (HR 2,20; 95% BI 1,61-3,01), hogere cardiovasculaire mortaliteit (HR 2,45; 95% BI 1,64-3,66) en meer ziekenhuisopnames (HR 1,40; 95% BI 1,12-1,74). De effectgrootte was vergelijkbaar met andere zware prognostische factoren. De associatie was consistent over diverse populaties — hoog/middel/laag inkomen, alle HF-etiologieën, alle HF-typen. Zelfs binnen het 'normale' bereik (z >-2) gaven lagere waarden meer hartfalenlast en mindere kwaliteit van leven. Conclusie: FEV1 is een onderbenutte prognostische biomarker in hartfalen. Routine-spirometrie verdient een plek in de hartfalen-workup naast conventionele risicostratificatie — internationaal én in de Nederlandse hartfalenpoli, waar comorbide COPD vaak onderbelicht blijft.","abstract_original":"Aims: Pulmonary abnormalities are common in HF and may have prognostic implications. Current evidence is largely 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 multinational HF cohort. Methods: 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; followed for median 3.8 years (IQR 2.1–5.0). Baseline FEV1 was transformed into z-scores standardised for age, sex, and height. The association between baseline FEV1 with all-cause mortality, cardiovascular (CV) deaths and all-cause hospitalisations were examined. Results: 3,359 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 >-2) showed increasing HF burden, 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 mortality (HR 2.20; 95% CI 1.61–3.01), CV mortality (HR 2.45; 95% CI 1.64–3.66) and hospitalisations (HR 1.40; 95% CI 1.12–1.74). Effect sizes were comparable to other major prognostic factors. Associations were consistent across populations from diverse socio-economic development, HF aetiology and HF type. Conclusions: FEV1 is a major, independent prognostic factor in HF across global populations. Routine spirometry deserves a place in the HF workup alongside conventional risk stratification."}