TY - JOUR T1 - The association of lung function and pulmonary vasculature volume with cardiorespiratory fitness in the community JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01821-2021 SP - 2101821 AU - Jenna McNeill AU - Ariel Chernofsky AU - Matthew Nayor AU - Farbod N. Rahaghi AU - Raul San Jose Estepar AU - George Washko AU - Andrew Synn AU - Ramachandran S. Vasan AU - George O'Connor AU - Martin G. Larson AU - Jennifer E. Ho AU - Gregory D. Lewis Y1 - 2021/01/01 UR - http://erj.ersjournals.com/content/early/2021/12/09/13993003.01821-2021.abstract N2 - Introduction Cardiorespiratory fitness is not limited by pulmonary mechanical reasons in the majority of adults. However, the degree to which lung function contributes to exercise response patterns among ostensibly healthy individuals remains unclear.Methods We examined 2314 Framingham Heart Study participants who underwent cardiopulmonary exercise testing (CPET) and pulmonary function testing. We investigated the association of FEV1, FVC, FEV1/FVC and DLCO with the primary outcome of peak VO2, along with other CPET parameters using multivariable linear regression. Finally, we investigated the association of total and peripheral pulmonary blood vessel volume with peak VO2.Results We found lower FEV1, FVC and DLCO were associated with lower peak VO2. For example, a one-liter lower FEV1 and FVC were associated with 7.1% (95% CI: 5.1%, 9.1%) and 6.0% (95% CI: 4.3%, 7.7%) lower peak VO2, respectively. By contrast, FEV1/FVC ratio was not associated with peak VO2. Lower lung function was associated with lower oxygen uptake efficiency slope oxygen pulse slope, VO2 at AT, VE at AT and breathing reserve. In addition, lower total and peripheral pulmonary blood vessel volume were associated with a lower peak VO2.Conclusion In a large, community-based cohort of adults, we found lower FEV1, FVC and DLCO were associated with lower exercise capacity, as well as oxygen uptake efficiency slope and ventilatory efficiency. In addition, lower total and peripheral pulmonary blood vessel volume were associated with lower peak VO2. These findings underscore the importance of lung function and blood vessel volume as contributors to overall exercise capacity.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. McNeill has nothing to disclose.Conflict of interest: Dr. Chernofsky has nothing to disclose.Conflict of interest: Dr. Nayor reports grants from NIH, during the conduct of the study.Conflict of interest: Farod N. Rahaghi has nothing to disclose.Conflict of interest: Raul San Jose Estepar has nothing to disclose.Conflict of interest: Dr. Washko reports grants from the NIH, DoD, Boehringer Ingelheim, Janssen Pharmaceuticals, BTG Therapeutics, Pulmonx, Lung Biotechnology and Insmed. Dr Washko reports participation in advisory boards and consultancies for Boehringer Ingelheim, CSL Behring, Novartis, Phillips, and Vertex Pharmaceuticals. Dr. Washko is a co-founder and equity share holder in Quantitative Imaging Solutions, a company that provides consulting services for image and data analytics. Finally, Dr. Washko's spouse works for Biogen.Conflict of interest: Dr. Synn reports grants from American Lung Association, grants from NHLBI, outside the submitted work;.Conflict of interest: Dr. Vasan has nothing to disclose.Conflict of interest: Dr. O'Connor has nothing to disclose.Conflict of interest: Dr. Larson has nothing to disclose.Conflict of interest: Dr. Ho reports grants from NIH/NHLBI, during the conduct of the study; grants from Gilead Sciences, grants from Bayer AG, other from EcoNugenics Inc, outside the submitted work;.Conflict of interest: Dr. Lewis reports grants from Amgen, grants from Cytokinetics, grants from Astra Zeneca, grants from Applied Therapeutics, grants from Sonivie, personal fees and other from American Regent, outside the submitted work;. ER -