Document Detail

The Diagnostic Importance of a Reduced FEV(1)/FEV(6).
MedLine Citation:
PMID:  22292595     Owner:  NLM     Status:  In-Data-Review    
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.
Zachary Q Morris; Najia Huda; Robert R Burke
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  COPD     Volume:  9     ISSN:  1541-2563     ISO Abbreviation:  COPD     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101211769     Medline TA:  COPD     Country:  England    
Other Details:
Languages:  eng     Pagination:  22-8     Citation Subset:  IM    
1Henry Ford Health System, Division of Pulmonary and Critical Care Medicine , Detroit, Michigan , USA.
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