Title | Forced Expiratory Flow at 25%-75% Links COPD Physiology to Emphysema and Disease Severity in the SPIROMICS Cohort. |
Publication Type | Publication |
Year | 2022 |
Authors | Ronish BE, Couper DJ, Barjaktarevic IZ, Cooper CB, Kanner RE, Pirozzi CS, Kim V, Wells JM, Han MK, Woodruff PG, Ortega VE, Peters SP, Hoffman EA, Buhr RG, Dolezal BA, Tashkin DP, Liou TG, Bateman LA, Schroeder JD, Martinez FJ, R Barr G, Hansel NN, Comellas AP, Rennard SI, Arjomandi M, Iii RPaine |
Journal | Chronic Obstr Pulm Dis |
Volume | 9 |
Issue | 2 |
Pagination | 111-121 |
Date Published | 2022 Apr 29 |
ISSN | 2372-952X |
Abstract | BACKGROUND: Forced expiratory volume in 1 second (FEV) 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]) as an additional tool for characterizing pathophysiology in COPD.OBJECTIVE: To determine whether FEF 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 (%predFEF) and both clinical markers and computed tomography (CT) findings of smoking-related lung disease.RESULTS: Lower %predFEF 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 remained significantly associated with increased emphysema, functional small airways disease, TLC, and BDR after adjustment for FEV or forced vital capacity (FVC).INTERPRETATION: The %predFEF provides additional information about disease manifestation beyond FEV. These associations may reflect loss of elastic recoil and air trapping from emphysema and intrinsic small airways disease. Thus, %predFEF helps link the anatomic pathology and deranged physiology of COPD. |
DOI | 10.15326/jcopdf.2021.0241 |
Alternate Journal | Chronic Obstr Pulm Dis |
PubMed ID | 35114743 |
PubMed Central ID | PMC9166328 |
Grant List | HHSN268200900019C / HL / NHLBI NIH HHS / United States K24 HL137013 / HL / NHLBI NIH HHS / United States HHSN268200900015C / HL / NHLBI NIH HHS / United States HHSN268200900016C / HL / NHLBI NIH HHS / United States R01 HL148215 / HL / NHLBI NIH HHS / United States U01 HL137880 / HL / NHLBI NIH HHS / United States R01 HL150023 / HL / NHLBI NIH HHS / United States HHSN268200900014C / HL / NHLBI NIH HHS / United States U24 HL141762 / HL / NHLBI NIH HHS / United States L30 HL134025 / HL / NHLBI NIH HHS / United States HHSN268200900017C / HL / NHLBI NIH HHS / United States HHSN268200900020C / HL / NHLBI NIH HHS / United States HHSN268200900013C / HL / NHLBI NIH HHS / United States KL2 TR001882 / TR / NCATS NIH HHS / United States TL1 TR001883 / TR / NCATS NIH HHS / United States |
Forced Expiratory Flow at 25%-75% Links COPD Physiology to Emphysema and Disease Severity in the SPIROMICS Cohort.
MS#:
MS183
Manuscript Full Title:
Forced Expiratory Flow at 25%-75% Links COPD Physiology to Emphysema and Disease Severity in the SPIROMICS Cohort.
ECI:
Manuscript Status:
Published and Public