A Novel Spirometric Measure Identifies Mild COPD Unidentified by Standard Criteria

Asli Gorek Dilektasli; Janos Porszasz; Richard Casaburi; William W Stringer; Surya P Bhatt; Youngju Pak; Harry B Rossiter; George Washko; Peter J Castaldi; Raul San Jose Estepar; James E Hansen; COPDGene investigators

doi:10.1016/j.chest.2016.06.047

Back

A Novel Spirometric Measure Identifies Mild COPD Unidentified by Standard Criteria

Journal article

Open access

Peer reviewed

A Novel Spirometric Measure Identifies Mild COPD Unidentified by Standard Criteria

Asli Gorek Dilektasli, Janos Porszasz, Richard Casaburi, William W Stringer, Surya P Bhatt, Youngju Pak, Harry B Rossiter, George Washko, Peter J Castaldi, Raul San Jose Estepar, …

Chest, Vol.150(5), pp.1080-1090

11/2016

DOI: 10.1016/j.chest.2016.06.047

PMCID: PMC5103018

PMID: 27452770

Files and links (1)

url

https://doi.org/10.1016/j.chest.2016.06.047View

Published (Version of record) Open Access

Abstract

In chronic obstructive pulmonary disease, both smaller and larger airways are affected. FEV1 mainly reflects large airways obstruction, while the later fraction of forced exhalation reflects reduction in terminal expiratory flow. In this study, the objective was to evaluate the relationship between spirometric ratios, including the ratio of forced expiratory volume in 3 and 6 seconds (FEV3/FEV6), and small airways measures and gas trapping at quantitative chest CT scanning, and clinical outcomes in the Genetic Epidemiology of COPD (COPDGene) cohort. Seven thousand eight hundred fifty-three current and ex-smokers were evaluated for airflow obstruction by using recently defined linear iteratively derived equations of Hansen et al to determine lower limit of normal (LLN) equations for prebronchodilator FEV1/FVC, FEV1/FEV6, FEV3/FEV6, and FEV3/FVC. General linear and ordinal regression models were applied to the relationship between prebronchodilator spirometric and radiologic and clinical data. Of the 10,311 participants included in the COPDGene phase I study, participants with incomplete quantitative CT scanning or relevant spirometric data were excluded, resulting in 7,853 participants in the present study. Of 4,386 participants with FEV1/FVC greater than or equal to the LLN, 15.4% had abnormal FEV3/FEV6. Compared with normal FEV3/FEV6 and FEV1/FVC, abnormal FEV3/FEV6 was associated with significantly greater gas trapping; St. George’s Respiratory Questionnaire score; modified Medical Research Council dyspnea score; and BMI, airflow obstruction, dyspnea, and exercise index and with shorter 6-min walking distance (all P < .0001) but not with CT scanning evidence of emphysema. Current and ex-smokers with prebronchodilator FEV3/FEV6 less than the LLN as the sole abnormality identifies a distinct population with evidence of small airways disease in quantitative CT scanning, impaired indexes of physical function and quality of life otherwise deemed normal by using the current spirometric definition.

airway obstruction

spirometry

thoracic radiology

COPD

Details

Title: Subtitle: A Novel Spirometric Measure Identifies Mild COPD Unidentified by Standard Criteria
Creators: Asli Gorek Dilektasli - Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
Janos Porszasz - Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
Richard Casaburi - Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
William W Stringer - Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
Surya P Bhatt - Division of Pulmonary, Allergy and Critical Care Medicine, UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, AL
Youngju Pak - UCLA Clinical and Translational Science Institute, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
Harry B Rossiter - Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
George Washko - Brigham and Women’s Hospital Clinics, Brigham and Women’s Hospital, Boston, MA
Peter J Castaldi - Channing Division of Network Medicine and Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA
Raul San Jose Estepar - Brigham and Women’s Hospital Clinics, Brigham and Women’s Hospital, Boston, MA
James E Hansen - Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
COPDGene investigators
Contributors: Eric A Hoffman (Contributor) - University of Iowa, Radiology
Resource Type: Journal article
Publication Details: Chest, Vol.150(5), pp.1080-1090
DOI: 10.1016/j.chest.2016.06.047
PMID: 27452770
PMCID: PMC5103018
NLM abbreviation: Chest
ISSN: 0012-3692
eISSN: 1931-3543
Publisher: Elsevier Inc
Language: English
Date published: 11/2016
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
Record Identifier: 9984051997002771

Metrics

27 Record Views

50 Times Cited - Web of Science

See more details