Journal article
Low FVC/TLC in Preserved Ratio Impaired Spirometry (PRISm) is associated with features of and progression to obstructive lung disease
Scientific reports, Vol.10(1), pp.5169-5169
03/20/2020
DOI: 10.1038/s41598-020-61932-0
PMCID: PMC7083974
PMID: 32198360
Abstract
One quarter of individuals with Preserved Ratio Impaired Spirometry (PRISm) will develop airflow obstruction, but there are no established methods to identify these individuals. We examined the utility of FVC/TLC in identifying features of obstructive lung disease. The ratio of post-bronchodilator FVC and TLCCT from chest CT (FVC/TLCCT) among current and former smokers with PRISm (FEV1/FVC >= 0.7 and FEV1 < 80%) in COPDGene was used to stratify subjects into quartiles: very high, high, low, and very low. We examined the associations between FVC/TLCCT quartiles and (1) baseline characteristics, (2) respiratory exacerbations, (3) progression to COPD at 5 years, and (4) all-cause mortality. Among participants with PRISm at baseline (n = 1,131), the very low FVC/TLCCT quartile was associated with increased gas trapping and emphysema, and higher rates of progression to COPD at 5 years (36% versus 17%; p < 0.001) relative to the very high quartile. The very low FVC/TLCCT quartile was associated with increased total (IRR = 1.65; 95% CI [1.07-2.54]) and severe (IRR = 2.24; 95% CI [1.29-3.89]) respiratory exacerbations. Mortality was lower in the very high FVC/TLCCT quartile relative to the other quartiles combined. Reduced FVC/TLCCT ratio in PRISm is associated with increased symptoms, radiographic emphysema and gas trapping, exacerbations, and progression to COPD.
Details
- Title: Subtitle
- Low FVC/TLC in Preserved Ratio Impaired Spirometry (PRISm) is associated with features of and progression to obstructive lung disease
- Creators
- Spyridon Fortis - University of Iowa Hospitals and ClinicsAlejandro Comellas - University of Iowa Hospitals and ClinicsVictor Kim - Temple UniversityRichard Casaburi - The Lundquist InstituteJohn E. Hokanson - Colorado School of Public HealthJames D. Crapo - National Jewish HealthEdwin K. Silverman - Brigham and Women's HospitalEmily S. Wan - Brigham and Women's Hospital
- Resource Type
- Journal article
- Publication Details
- Scientific reports, Vol.10(1), pp.5169-5169
- DOI
- 10.1038/s41598-020-61932-0
- PMID
- 32198360
- PMCID
- PMC7083974
- NLM abbreviation
- Sci Rep
- ISSN
- 2045-2322
- eISSN
- 2045-2322
- Publisher
- Springer Nature
- Number of pages
- 11
- Grant note
- 14380 / Department of Veterans Affairs, Veterans Health Administration, Office of Rural Health, Veterans Rural Health Resource Center; US Department of Veterans Affairs CIN 13-412 / Health Services Research and evelopment (HSR&D) Service through the Comprehensive Access and Delivery Research and Evaluation (CADRE) Center U01 HL089897; U01 HL089856 / 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) IK2RX002165 / Veterans Affairs Rehabilitation Research and Development
- Language
- English
- Date published
- 03/20/2020
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984359895802771
Metrics
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