| The Diagnostic Importance of a Reduced FEV(1)/FEV(6). | |
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MedLine Citation:
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PMID: 22292595 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Abstract Background: On spirometry the FEV(1)/FEV(6) ratio has been advocated as a surrogate for the FEV(1)/FVC. The significance of isolated reductions in either the FEV(1)/FEV(6) or FEV(1)/FVC is not known. Methods: First-time adult spirograms (n = 22,837), with concomitant lung volumes (n = 12,040), diffusion (n = 14,154), and inspiratory capacity (n = 12,480) were studied. Four groups were compared. 1) Only FEV(1)/FEV(6) reduced (n = 302). 2) Only FEV(1)/FVC reduced (n = 1158). 3) Both ratios reduced (n = 6593). 4) Both ratios normal (n = 14,784). Results: In patients with obstructed spirometry (either a reduced FEV(1)/FVC and/or FEV(1)/FEV(6)), 3.8% only had a reduced FEV(1)/FEV(6), while 14.4% only had a reduced FEV(1)/FVC. The mean FEV(1) was lower when both ratios were reduced. The group with only a reduced FEV(1)/FEV(6), compared to only the FEV(1)/FVC reduced, had a lower FEV(1), FVC, BMI, Expiratory Time, and IC (p values < 0.0001). DLCO was also lower (p = 0.005), and the FEV(1)/FVC and RV/TLC were higher (p values < 0.0001). When the patients with only a reduced FEV(1)/FEV(6) had a subsequent spirogram, 60% had a reduced FEV(1)/FVC when their mean expiratory times were 3.5 seconds longer. Ninety percent of this group had strong clinical evidence of airways obstruction. Conclusions: The FEV(1)/FEV(6) is not as sensitive as the FEV(1)/FVC for diagnosing airways obstruction, but in the presence of a normal FEV(1)/FVC, subjects have greater physiologic abnormalities than when only the FEV(1)/FVC is reduced. The FEV(1)/FEV(6) ratio should not replace the FEV(1)/FVC as the standard for airways obstruction, but there is benefit including this measurement to identify individuals with greater air trapping and diffusion abnormalities. |
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Authors:
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Zachary Q Morris; Najia Huda; Robert R Burke |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: COPD Volume: 9 ISSN: 1541-2563 ISO Abbreviation: COPD Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-02-01 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101211769 Medline TA: COPD Country: England |
Other Details:
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Languages: eng Pagination: 22-8 Citation Subset: IM |
Affiliation:
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1Henry Ford Health System, Division of Pulmonary and Critical Care Medicine , Detroit, Michigan , USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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