Forced Expiratory Flow at 25%-75% Links COPD Physiology to Emphysema and Disease Severity in the SPIROMICS Cohort
JCOPDF © 2022..
BACKGROUND: Forced expiratory volume in 1 second (FEV1) 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% [FEF25%-75%]) as an additional tool for characterizing pathophysiology in COPD.
OBJECTIVE: To determine whether FEF25%-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 FEF25%-75% (%predFEF25%-75%) and both clinical markers and computed tomography (CT) findings of smoking-related lung disease.
RESULTS: Lower %predFEF25-75% 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 %predFEF25-75% remained significantly associated with increased emphysema, functional small airways disease, TLC, and BDR after adjustment for FEV1 or forced vital capacity (FVC).
INTERPRETATION: The %predFEF25-75% provides additional information about disease manifestation beyond FEV1. These associations may reflect loss of elastic recoil and air trapping from emphysema and intrinsic small airways disease. Thus, %predFEF25-75% helps link the anatomic pathology and deranged physiology of COPD.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
Chronic obstructive pulmonary diseases (Miami, Fla.) - 9(2022), 2 vom: 29. Apr., Seite 111-121 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ronish, Bonnie E [VerfasserIn] |
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| Links: |
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| Themen: |
Emphysema |
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| Anmerkungen: |
Date Revised 15.06.2023 published: Print Citation Status PubMed-not-MEDLINE |
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| doi: |
10.15326/jcopdf.2021.0241 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 100 | 1 | |a Ronish, Bonnie E |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Forced Expiratory Flow at 25%-75% Links COPD Physiology to Emphysema and Disease Severity in the SPIROMICS Cohort |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Revised 15.06.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a JCOPDF © 2022. | ||
| 520 | |a BACKGROUND: Forced expiratory volume in 1 second (FEV1) 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% [FEF25%-75%]) as an additional tool for characterizing pathophysiology in COPD | ||
| 520 | |a OBJECTIVE: To determine whether FEF25%-75% helps predict clinical and radiographic abnormalities in COPD | ||
| 520 | |a 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 FEF25%-75% (%predFEF25%-75%) and both clinical markers and computed tomography (CT) findings of smoking-related lung disease | ||
| 520 | |a RESULTS: Lower %predFEF25-75% 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 %predFEF25-75% remained significantly associated with increased emphysema, functional small airways disease, TLC, and BDR after adjustment for FEV1 or forced vital capacity (FVC) | ||
| 520 | |a INTERPRETATION: The %predFEF25-75% provides additional information about disease manifestation beyond FEV1. These associations may reflect loss of elastic recoil and air trapping from emphysema and intrinsic small airways disease. Thus, %predFEF25-75% helps link the anatomic pathology and deranged physiology of COPD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a FEF25-75% | |
| 650 | 4 | |a emphysema | |
| 650 | 4 | |a functional small airways disease | |
| 650 | 4 | |a mid-flow rate | |
| 650 | 4 | |a pulmonary physiology | |
| 650 | 4 | |a spirometry | |
| 700 | 1 | |a Couper, David J |e verfasserin |4 aut | |
| 700 | 1 | |a Barjaktarevic, Igor Z |e verfasserin |4 aut | |
| 700 | 1 | |a Cooper, Christopher B |e verfasserin |4 aut | |
| 700 | 1 | |a Kanner, Richard E |e verfasserin |4 aut | |
| 700 | 1 | |a Pirozzi, Cheryl S |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Victor |e verfasserin |4 aut | |
| 700 | 1 | |a Wells, James M |e verfasserin |4 aut | |
| 700 | 1 | |a Han, MeiLan K |e verfasserin |4 aut | |
| 700 | 1 | |a Woodruff, Prescott G |e verfasserin |4 aut | |
| 700 | 1 | |a Ortega, Victor E |e verfasserin |4 aut | |
| 700 | 1 | |a Peters, Stephen P |e verfasserin |4 aut | |
| 700 | 1 | |a Hoffman, Eric A |e verfasserin |4 aut | |
| 700 | 1 | |a Buhr, Russell G |e verfasserin |4 aut | |
| 700 | 1 | |a Dolezal, Brett A |e verfasserin |4 aut | |
| 700 | 1 | |a Tashkin, Donald P |e verfasserin |4 aut | |
| 700 | 1 | |a Liou, Theodore G |e verfasserin |4 aut | |
| 700 | 1 | |a Bateman, Lori A |e verfasserin |4 aut | |
| 700 | 1 | |a Schroeder, Joyce D |e verfasserin |4 aut | |
| 700 | 1 | |a Martinez, Fernando J |e verfasserin |4 aut | |
| 700 | 1 | |a Barr, R Graham |e verfasserin |4 aut | |
| 700 | 1 | |a Hansel, Nadia N |e verfasserin |4 aut | |
| 700 | 1 | |a Comellas, Alejandro P |e verfasserin |4 aut | |
| 700 | 1 | |a Rennard, Stephen I |e verfasserin |4 aut | |
| 700 | 1 | |a Arjomandi, Mehrdad |e verfasserin |4 aut | |
| 700 | 1 | |a Paine Iii, Robert |e verfasserin |4 aut | |
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