Journal article
Forced Expiratory Flow at 25%-75% Links COPD Physiology to Emphysema and Disease Severity in the SPIROMICS Cohort
Chronic obstructive pulmonary diseases, Vol.9(2), pp.111-121
02/02/2022
DOI: 10.15326/jcopdf.2021.0241
PMCID: PMC9166328
PMID: 35114743
Abstract
Background:
Forced expiratory volume in 1 second (FEV
1
) is central to the diagnosis of chronic obstructive pulmonary disease (COPD) but is imprecise in classifying disease burden. We examined the potential of the maximal mid-expiratory flow rate (forced expiratory flow rate between 25% and 75% [FEF
25%-75%
]) as an additional tool for characterizing pathophysiology in COPD.
Objective:
To determine whether FEF
25%-75%
helps predict clinical and radiographic abnormalities in COPD.
Study Design and Methods:
The SubPopulations and InteRediate Outcome Measures In COPD Study (SPIROMICS) enrolled a prospective cohort of 2978 nonsmokers and ever-smokers, with and without COPD, to identify phenotypes and intermediate markers of disease progression. We used baseline data from 2771 ever-smokers from the SPIROMICS cohort to identify associations between percent predicted FEF
25%-75%
(%predFEF
25%-75%
) and both clinical markers and computed tomography (CT) findings of smoking-related lung disease.
Results:
Lower %predFEF
25-75%
was associated with more severe disease, manifested radiographically by increased functional small airways disease, emphysema (most notably with homogeneous distribution), CT-measured residual volume, total lung capacity (TLC), and airway wall thickness, and clinically by increased symptoms, decreased 6-minute walk distance, and increased bronchodilator responsiveness (BDR). A lower %predFEF
25-75%
remained significantly associated with increased emphysema, functional small airways disease, TLC, and BDR after adjustment for FEV
1
or forced vital capacity (FVC).
Interpretation:
The %predFEF
25-75%
provides additional information about disease manifestation beyond FEV
1
. These associations may reflect loss of elastic recoil and air trapping from emphysema and intrinsic small airways disease. Thus, %predFEF
25-75%
helps link the anatomic pathology and deranged physiology of COPD.
Details
- Title: Subtitle
- Forced Expiratory Flow at 25%-75% Links COPD Physiology to Emphysema and Disease Severity in the SPIROMICS Cohort
- Creators
- Bonnie E. Ronish - University of UtahDavid J. Couper - University of North Carolina at Chapel HillIgor Z. Barjaktarevic - University of California, Los AngelesChristopher B. Cooper - University of California, Los AngelesRichard E. Kanner - University of UtahCheryl S. Pirozzi - University of UtahVictor Kim - Temple University HospitalJames M. Wells - University of Alabama at BirminghamMeiLan K. Han - University of MichiganPrescott G. Woodruff - University of California, San FranciscoVictor E. Ortega - Wake Forest UniversityStephen P. Peters - Wake Forest UniversityEric A. Hoffman - University of IowaRussell G. Buhr - VA Greater Los Angeles Healthcare SystemBrett A. Dolezal - University of California, Los AngelesDonald P. Tashkin - University of California, Los AngelesTheodore G. Liou - University of UtahLori A. Bateman - University of North Carolina at Chapel HillJoyce D. Schroeder - University of UtahFernando J. Martinez - Cornell UniversityR. Graham Barr - Columbia UniversityNadia N. Hansel - Johns Hopkins MedicineAlejandro P. Comellas - University of IowaStephen I. Rennard - University of Nebraska Medical CenterMehrdad Arjomandi - University of California, San FranciscoRobert Paine III - Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, University of Utah, Salt Lake City, Utah, United States
- Resource Type
- Journal article
- Publication Details
- Chronic obstructive pulmonary diseases, Vol.9(2), pp.111-121
- DOI
- 10.15326/jcopdf.2021.0241
- PMID
- 35114743
- PMCID
- PMC9166328
- NLM abbreviation
- Chronic Obstr Pulm Dis
- ISSN
- 2372-952X
- eISSN
- 2372-952X
- Publisher
- COPD Foundation Inc
- Alternative title
- FEF25%-75% Linked to Emphysema and Disease Severity
- Language
- English
- Date published
- 02/02/2022
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984318712102771
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