Spirometric indices of early airflow impairment in individuals at risk of developing COPD: Spirometry beyond FEV1/FVC

Daniel Hoesterey; Nilakash Das; Wim Janssens; Russell G Buhr; Fernando J Martinez; Christopher B Cooper; Donald P Tashkin; Igor Barjaktarevic

doi:10.1016/j.rmed.2019.08.004

Spirometric indices of early airflow impairment in individuals at risk of developing COPD: Spirometry beyond FEV₁/FVC

Respir Med. 2019 Sep:156:58-68. doi: 10.1016/j.rmed.2019.08.004. Epub 2019 Aug 9.

Authors

Daniel Hoesterey¹, Nilakash Das², Wim Janssens², Russell G Buhr³, Fernando J Martinez⁴, Christopher B Cooper⁵, Donald P Tashkin¹, Igor Barjaktarevic⁶

Affiliations

¹ Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA.
² Laboratory of Respiratory Diseases, Department of Chronic Diseases, Metabolism and Ageing, Katholieke Universiteit Leuven, Leuven, Belgium.
³ Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA; Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, USA; Medical Service, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, USA.
⁴ Department of Medicine, Weill Cornell Medical College, USA.
⁵ Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA; Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, USA.
⁶ Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA. Electronic address: ibarjaktarevic@mednet.ucla.edu.

Abstract

Spirometry is the current gold standard for diagnosing and monitoring the progression of Chronic Obstructive Pulmonary Disease (COPD). However, many current and former smokers who do not meet established spirometric criteria for the diagnosis of this disease have symptoms and clinical courses similar to those with diagnosed COPD. Large longitudinal observational studies following individuals at risk of developing COPD offer us additional insight into spirometric patterns of disease development and progression. Analysis of forced expiratory maneuver changes over time may allow us to better understand early changes predictive of progressive disease. This review discusses the theoretical ability of spirometry to capture fine pathophysiologic changes in early airway disease, highlights the shortcomings of current diagnostic criteria, and reviews existing evidence for spirometric measures which may be used to better detect early airflow impairment.

Keywords: Early COPD; Obstruction; Spirometry.

Publication types

Review

MeSH terms

Forced Expiratory Volume*
Pulmonary Disease, Chronic Obstructive / diagnosis*
Pulmonary Disease, Chronic Obstructive / physiopathology*
Risk
Spirometry*
Vital Capacity*

Abstract

Publication types

MeSH terms

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