Journal article
Significance of FEV3/FEV(6 )in Recognition of Early Airway Disease in Smokers at Risk of Development of COPD Analysis of the SPIROMICS Cohort
Chest, Vol.161(4), pp.949-959
04/01/2022
DOI: 10.1016/j.chest.2021.10.046
PMCID: PMC9005864
PMID: 34767825
Abstract
BACKGROUND: Small airways are known to be affected early in the course of COPD; however, traditional spirometric indices may not accurately identify small airways disease. RESEARCH QUESTION: Can forced expiratory volume in 3 s/forced expiratory volume in 6 s (FEV3/FEV6) identify early airflow abnormalities and predict future clinically important respiratory-related outcomes, including development of COPD? STUDY DESIGN AND METHODS: The study included 832 current and former smokers with postbronchodilator FEV1/FVC >= 0.7 from the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) cohort. Participants were classified as having a reduced pre-bronchodilator FEV3/FEV6 based on lower limit of normal (LLN) values. Repeatability analysis was performed for FEV(3 )and FEV6. Regression modeling was used to evaluate the relationship between baseline FEV3/FEV6 and outcome measures, including functional small airways disease, on thoracic imaging and respiratory exacerbations. Interval censored analysis was used to assess progression to COPD. RESULTS: FEV3/FEV6 less than the LLN at baseline, defined as reduced compared with FEV3/FEV6 at or above the LLN, was associated with lower FEV1, poorer health status (St. George's Respiratory Questionnaire score), more emphysema, and more functional small airways disease on quantitative imaging. FEV(3 )and FEV6 showed excellent agreement between repeat measurements. A reduced FEV3/FEV6 was associated with increased odds of a severe respiratory exacerbation within the first year of follow-up and decreased time to first exacerbation. A low FEV3/FEV6 was also associated with development of COPD according to spirometry results (post-bronchodilator FEV1/FVC < 0.7) during study follow-up. INTERPRETATION: FEV3/FEV6 is a routinely available and repeatable spirometric index that can be useful in the evaluation of early airflow obstruction in current and former smokers without COPD. A reduced FEV3/FEV6 can identify those at risk for future development of COPD and respiratory exacerbations.
Details
- Title: Subtitle
- Significance of FEV3/FEV(6 )in Recognition of Early Airway Disease in Smokers at Risk of Development of COPD Analysis of the SPIROMICS Cohort
- Creators
- Nathan Yee - University of California, Los AngelesDaniela Markovic - Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, Los Angeles, CA, United States.Russell G. Buhr - University of California, Los AngelesSpyridon FortisMehrdad Arjomandi - University of California, San FranciscoDavid Couper - University of North Carolina at Chapel HillWayne H. Anderson - University of North Carolina at Chapel HillRobert Paine - University of UtahPrescott G. Woodruff - University of California, San FranciscoMeilan K. Han - University of MichiganFernando J. Martinez - Cornell UniversityR. Graham Barr - Columbia UniversityJames M. Wells - University of Alabama at BirminghamVictor E. Ortega - Wake Forest UniversityEric A. Hoffman - Roy J. and Lucille A. Carver College of MedicineVictor Kim - Temple UniversityM. Bradley Drummond - Univ N Carolina, Dept Med, Chapel Hill, NC 27515 USARussell P. Bowler - National Jewish HealthJeffrey L. Curtis - University of Michigan–Ann ArborChristopher B. Cooper - University of California, Los AngelesDonald P. Tashkin - University of California, Los AngelesIgor Z. Barjaktarevic - University of California, Los Angeles
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.161(4), pp.949-959
- DOI
- 10.1016/j.chest.2021.10.046
- PMID
- 34767825
- PMCID
- PMC9005864
- NLM abbreviation
- Chest
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Publisher
- Elsevier
- Number of pages
- 11
- Grant note
- Regeneron Pharmaceuticals, Inc.; Regeneron Takeda Pharmaceutical Company; Takeda Pharmaceutical Company Ltd Grifols Therapeutics, Inc. ProterixBio Theravance Biopharma Viatris COPD Foundation from AstraZeneca/MedImmune; AstraZeneca; Medimmune Boehringer Ingelheim Pharmaceuticals, Inc.; Boehringer Ingelheim HHSN268200900013C; HHSN268200900014C; HHSN268200900015C; HHSN268200900016C; HHSN268200900017C; HHSN268200900018C; HHSN268200900019C; HHSN268200900020C; U01 HL137880; U24 HL141762 / National Institutes of Health (NIH) /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) Bellerophon Therapeutics GlaxoSmithKline Bayer; Bayer AG Chiesi Farmaceutici S.p.A.; Chiesi Pharmaceuticals Inc Novartis Pharmaceuticals Corporation; Novartis Sunovion Sanofi Ikaria, Inc. Nycomed GmbH Foundation for the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Forest Research Institute, Inc.
- Language
- English
- Date published
- 04/01/2022
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984318822102771
Metrics
19 Record Views