Journal article
Clinical Significance of Bronchodilator Responsiveness Evaluated by Forced Vital Capacity in COPD: SPIROMICS Cohort Analysis
International journal of chronic obstructive pulmonary disease, Vol.14, pp.2927-2938
01/01/2019
DOI: 10.2147/COPD.S220164
PMCID: PMC6930016
PMID: 31908441
Abstract
Objective: Bronchodilator responsiveness (BDR) is prevalent in COPD, but its clinical implications remain unclear. We explored the significance of BDR, defined by post-bronch-odilator change in FEV1 (BDRFEV1) as a measure reflecting the change in flow and in FVC (BDRFVC) reflecting the change in volume.
Methods: We analyzed 2974 participants from a multicenter observational study designed to identify varying COPD phenotypes (SPIROMICS). We evaluated the association of BDR with baseline clinical characteristics, rate of prospective exacerbations and mortality using negative binomial regression and Cox proportional hazards models.
Results: A majority of COPD participants exhibited BDR (52.7%). BDRFEV1 occurred more often in earlier stages of COPD, while BDRFVC occurred more frequently in more advanced disease. When defined by increases in either FEV1 or FVC, BDR was associated with a self-reported history of asthma, but not with blood eosinophil counts. BDRFVC was more prevalent in subjects with greater emphysema and small airway disease on CT. In a univariate analysis, BDRFVC was associated with increased exacerbations and mortality, although no significance was found in a model adjusted for post-bronchodilator FEV1.
Conclusion: With advanced airflow obstruction in COPD, BDRFVC is more prevalent in comparison to BDRFEV1 and correlates with the extent of emphysema and degree of small airway disease. Since these associations appear to be related to the impairment of FEV1, BDRFVC itself does not define a distinct phenotype nor can it be more predictive of outcomes, but it can offer additional insights into the pathophysiologic mechanism in advanced COPD.
Details
- Title: Subtitle
- Clinical Significance of Bronchodilator Responsiveness Evaluated by Forced Vital Capacity in COPD: SPIROMICS Cohort Analysis
- Creators
- Igor Z. Barjaktarevic - University of California, Los AngelesRussell G. Buhr - University of California, Los AngelesXiaoyan Wang - University of California, Los AngelesScott Hu - University of California, Los AngelesDavid Couper - University of North Carolina at Chapel HillWayne Anderson - University of North Carolina at Chapel HillRichard E. Kanner - University of UtahRobert Paine - University of UtahSurya P. Bhatt - University of Alabama at BirminghamNirav R. Bhakta - University of California, San FranciscoMehrdad Arjomandi - University of California, San FranciscoRobert J. Kaner - Cornell UniversityCheryl S. Pirozzi - University of UtahJeffrey L. Curtis - University of Michigan–Ann ArborWanda K. O'Neal - University of North Carolina at Chapel HillPrescott G. Woodruff - University of California, San FranciscoMeiLan K. Han - University of MichiganFernando J. Martinez - Cornell UniversityNadia Hansel - University of BaltimoreJames Michael Wells - University of Alabama at BirminghamVictor E. Ortega - Wake Forest UniversityEric A. Hoffman - University of IowaClaire M. Doerschuk - University of North Carolina at Chapel HillVictor Kim - Temple UniversityMark T. Dransfield - University of Alabama at BirminghamM. Bradley Drummond - Univ N Carolina, Dept Med, Chapel Hill, NC 27515 USARussell Bowler - National Jewish HealthGerard Criner - Temple UniversityStephanie A. Christenson - University of California, San FranciscoBonnie Ronish - University of UtahStephen P. Peters - Wake Forest UniversityJerry A. Krishnan - University of Illinois ChicagoDonald P. Tashkin - University of California, Los AngelesChristopher B. Cooper - University of California, Los AngelesNHLBI SubPopulations InteRmediate
- Resource Type
- Journal article
- Publication Details
- International journal of chronic obstructive pulmonary disease, Vol.14, pp.2927-2938
- DOI
- 10.2147/COPD.S220164
- PMID
- 31908441
- PMCID
- PMC6930016
- NLM abbreviation
- Int J Chron Obstruct Pulmon Dis
- ISSN
- 1178-2005
- eISSN
- 1178-2005
- Publisher
- Dove Medical Press Ltd
- Number of pages
- 12
- Grant note
- Regeneron Pharmaceuticals, Inc.; Regeneron Takeda Pharmaceutical Company; Takeda Pharmaceutical Company Ltd Chiesi Farmaceutici S.p.A. HHSN268200900013C; HHSN2682009 00014C; HHSN268200900015C; HHSN268200900016C; HHSN268200900017C; HHSN268200900018C; HHSN26 8200900019C; HHSN268200900020C / NIH/NHLBI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Grifols Therapeutics, Inc. Foundation for the NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA ProterixBio Boehringer-Ingelheim Pharmaceuticals, Inc.; Boehringer Ingelheim Bellerophon Therapeutics GlaxoSmithKline Bayer; Bayer AG Novartis Pharmaceuticals Corporation; Novartis Sunovion Sanofi K24HL137013 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) COPD Foundation from AstraZeneca/MedImmune Ikaria, Inc. Nycomed GmbH HL122438; HL138188 / NHLBI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Forest Research Institute, Inc.
- Language
- English
- Date published
- 01/01/2019
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984318796002771
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