Zachary Q Morris1, Angel Coz2, Dominik Starosta3. 1. Division of Pulmonary and Critical Care Medicine, Henry Ford Health System, Detroit, MI. Electronic address: zmorris1@hfhs.org. 2. Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, KY. 3. Division of Pulmonary and Critical Care Medicine, Henry Ford Health System, Detroit, MI.
Abstract
BACKGROUND: The FEV3/FVC ratio is not discussed in the American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines for lung function interpretation in spite of narrow confidence limits of normal and its association with smoking. We sought to determine whether a reduction in only the FEV3/FVC ratio was associated with physiologic changes compared with subjects with normal FEV1/FVC and FEV3/FVC ratios. METHODS: Lung volumes and diffusion were studied in individuals with concomitant spirometry. Patients with restriction on total lung capacity (TLC) were excluded, as were repeat tests on the same patient. A total of 13,302 subjects were divided into three groups: (1) normal FEV1/FVC and FEV3/FVC (n = 7,937); (2) only a reduced FEV3/FVC (n = 840); and (3) reduced FEV1/FVC (n = 4,525). RESULTS: Subjects with only a reduced FEV3/FVC compared with those with normal FEV1/FVC and FEV3/FVC ratios had higher mean % predicted TLC (99.1% vs 97.1%, P < .001), residual volume (RV) (109.4% vs 102.3%, P < .001), and RV/TLC ratio (110.1% vs 105.4%, P < .001). They had lower mean % predicted FEV1 (82.6% vs 90.2%, P < .001), inspiratory capacity (94.5% vs 98.2%, P < .001), and diffusing capacity of lung for carbon monoxide (Dlco) (78.3% vs 81.9%, P < .001). Their mean BMI was lower (30.8 vs 31.5, P < .005), they were older (61.2 vs 57.2, P < .001), and more likely male (52.0% vs 40.4%, P < .001), with no racial differences. Comparing this group to those with a reduced FEV1/FVC, similar but greater differences were noted in all of the previous measurements, though mean age and sex were not significantly different. CONCLUSIONS: The FEV3/FVC ratio should be routinely reported on spirometry. An isolated reduction may indicate an early injury pattern of hyperinflation, air trapping, and loss of Dlco.
BACKGROUND: The FEV3/FVC ratio is not discussed in the American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines for lung function interpretation in spite of narrow confidence limits of normal and its association with smoking. We sought to determine whether a reduction in only the FEV3/FVC ratio was associated with physiologic changes compared with subjects with normal FEV1/FVC and FEV3/FVC ratios. METHODS: Lung volumes and diffusion were studied in individuals with concomitant spirometry. Patients with restriction on total lung capacity (TLC) were excluded, as were repeat tests on the same patient. A total of 13,302 subjects were divided into three groups: (1) normal FEV1/FVC and FEV3/FVC (n = 7,937); (2) only a reduced FEV3/FVC (n = 840); and (3) reduced FEV1/FVC (n = 4,525). RESULTS: Subjects with only a reduced FEV3/FVC compared with those with normal FEV1/FVC and FEV3/FVC ratios had higher mean % predicted TLC (99.1% vs 97.1%, P &lt; .001), residual volume (RV) (109.4% vs 102.3%, P &lt; .001), and RV/TLC ratio (110.1% vs 105.4%, P &lt; .001). They had lower mean % predicted FEV1 (82.6% vs 90.2%, P &lt; .001), inspiratory capacity (94.5% vs 98.2%, P &lt; .001), and diffusing capacity of lung for carbon monoxide (Dlco) (78.3% vs 81.9%, P &lt; .001). Their mean BMI was lower (30.8 vs 31.5, P &lt; .005), they were older (61.2 vs 57.2, P &lt; .001), and more likely male (52.0% vs 40.4%, P &lt; .001), with no racial differences. Comparing this group to those with a reduced FEV1/FVC, similar but greater differences were noted in all of the previous measurements, though mean age and sex were not significantly different. CONCLUSIONS: The FEV3/FVC ratio should be routinely reported on spirometry. An isolated reduction may indicate an early injury pattern of hyperinflation, air trapping, and loss of Dlco.
Authors: Daniel Hoesterey; Nilakash Das; Wim Janssens; Russell G Buhr; Fernando J Martinez; Christopher B Cooper; Donald P Tashkin; Igor Barjaktarevic Journal: Respir Med Date: 2019-08-09 Impact factor: 3.415
Authors: Nathan Yee; Daniela Markovic; Russell G Buhr; Spyridon Fortis; Mehrdad Arjomandi; David Couper; Wayne H Anderson; Robert Paine; Prescott G Woodruff; Meilan K Han; Fernando J Martinez; R Graham Barr; James M Wells; Victor E Ortega; Eric A Hoffman; Victor Kim; M Bradley Drummond; Russell P Bowler; Jeffrey L Curtis; Christopher B Cooper; Donald P Tashkin; Igor Z Barjaktarevic Journal: Chest Date: 2021-11-10 Impact factor: 10.262
Authors: Asli Gorek Dilektasli; Janos Porszasz; Richard Casaburi; William W Stringer; Surya P Bhatt; Youngju Pak; Harry B Rossiter; George Washko; Peter J Castaldi; Raul San Jose Estepar; James E Hansen Journal: Chest Date: 2016-07-22 Impact factor: 9.410
Authors: Arthur F Gelb; Alfred Yamamoto; Eric K Verbeken; James C Hogg; Donald P Tashkin; Diem N T Tran; Roxanna M Moridzadeh; Christine Fraser; Mark J Schein; Marc Decramer; Eric F Glassy; Jay A Nadel Journal: Chronic Obstr Pulm Dis Date: 2021-01
Authors: Brian L Graham; Irene Steenbruggen; Martin R Miller; Igor Z Barjaktarevic; Brendan G Cooper; Graham L Hall; Teal S Hallstrand; David A Kaminsky; Kevin McCarthy; Meredith C McCormack; Cristine E Oropez; Margaret Rosenfeld; Sanja Stanojevic; Maureen P Swanney; Bruce R Thompson Journal: Am J Respir Crit Care Med Date: 2019-10-15 Impact factor: 21.405