Journal article
Reversible Airflow Obstruction Predicts Future Chronic Obstructive Pulmonary Disease Development in the SPIROMICS Cohort An Observational Cohort Study
American journal of respiratory and critical care medicine, Vol.206(5), pp.554-562
09/01/2022
DOI: 10.1164/rccm.202201-0094OC
PMCID: PMC9716898
PMID: 35549640
Abstract
Rationale: Chronic obstructive pulmonary disease (COPD) is defined by fixed spirometric ratio, FEV1/FVC, 0.70 after inhaled bronchodilators. However, the implications of variable obstruction (VO), in which the prebronchodilator FEV1/FVC ratio is less than 0.70 but increases to 0.70 or more after inhaled bronchodilators, have not been determined.
Objectives: We explored differences in physiology, exacerbations, and health status in participants with VO compared with reference participants without obstruction.
Methods: Data from the SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) cohort were obtained. Participants with VO were compared with reference participants without obstruction.
Measurements and Main Results: We assessed differences in baseline radiographic emphysema and small airway disease at study entry, baseline, and change in lung function by spirometry, functional capacity by 6-minute walk, health status using standard questionnaires, exacerbation rates, and progression to COPD between the two groups. All models were adjusted for participant characteristics, asthma history, and tobacco exposure. We assessed 175 participants with VO and 603 reference participants without obstruction. Participants with VO had 6.2 times the hazard of future development of COPD controlling for other factors (95% confidence interval, 4.6-8.3; P, 0.001). Compared with reference participants, the VO group had significantly lower baseline pre- and postbronchodilator (BD) FEV1, and greater decline over time in post-BD FEV1, and pre- and post-BD FVC. There were no significant differences in exacerbations between groups.
Conclusions: Significant risk for future COPD development exists for those with pre- but not post-BD airflow obstruction. These findings support consideration of expanding spirometric criteria defining COPD to include pre-BD obstruction.
Details
- Title: Subtitle
- Reversible Airflow Obstruction Predicts Future Chronic Obstructive Pulmonary Disease Development in the SPIROMICS Cohort An Observational Cohort Study
- Creators
- Russell G. Buhr - University of California SystemIgor Z. Barjaktarevic - University of California SystemP. Miguel Quibrera - University of North Carolina at Chapel HillLori A. Bateman - University of North Carolina at Chapel HillEugene R. Bleecker - University of ArizonaDavid J. Couper - University of North Carolina at Chapel HillJeffrey L. Curtis - University of Michigan–Ann ArborBrett A. Dolezal - University of California, Los AngelesMeiLan K. Han - University of Michigan–Ann ArborNadia N. Hansel - Johns Hopkins MedicineJerry A. Krishnan - University of Illinois at ChicagoFernando J. Martinez - Cornell UniversityWilliam McKleroy - University of California, San FranciscoRobert Paine - University of UtahStephen Rennard - University of Nebraska Medical CenterDonald P. Tashkin - University of California SystemPrescott G. Woodruff - University of California, San FranciscoRichard E. Kanner - University of UtahChristopher B. Cooper - University of California SystemSubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) InvestigatorsEric A Hoffman - Radiology
- Contributors
- Eric A Hoffman (Contributor) - University of Iowa, Radiology
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.206(5), pp.554-562
- Publisher
- Amer Thoracic Soc
- DOI
- 10.1164/rccm.202201-0094OC
- PMID
- 35549640
- PMCID
- PMC9716898
- ISSN
- 1073-449X
- eISSN
- 1535-4970
- Number of pages
- 9
- Grant note
- KL2TR001882 / NIH National Center for Advanced Translational Sciences grant HHSN268200900013C; HHSN268200900014C; HHSN268200900015C; HHSN268200900016C; HHSN268200900017C; HHSN268200900018C; HHSN268200900019C; HHSN268200900020C; U01HL137880; U24HL141762; L30HL134025 / NIH NHLBI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Language
- English
- Date published
- 09/01/2022
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984318685102771
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