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Vital capacity and COPD : The Swedish CArdioPulmonary bioImage Study (SCAPIS)

Torén, Kjell; Olin, Anna Carin; Lindberg, Anne LU ; Vikgren, Jenny; Schiöler, Linus; Brandberg, John; Johnsson, Åse; Engström, Gunnar LU ; Persson, H. Lennart and Sköld, Magnus, et al. (2016) In The International Journal of Chronic Obstructive Pulmonary Disease 11(1). p.927-933
Abstract

Background: Spirometric diagnosis of chronic obstructive pulmonary disease (COPD) is based on the ratio of forced expiratory volume in 1 second (FEV1)/vital capacity (VC), either as a fixed value 1/VC ratio in a general population setting. The second aim was to evaluate the characteristics of subjects with COPD who obtained a higher SVC than FVC. Methods: Subjects (n=1,050) aged 50-64 years were investigated with FEV1, FVC, and SVC after bronchodilation. Global Initiative for Chronic Obstructive Lung Disease (GOLD) COPDFVC was defined as FEV1/FVC VC as FEV1/VC FVC as FEV1/FVC below the LLN, and LLNCOPDVC as FEV1/VC below the LLN using the maximum... (More)

Background: Spirometric diagnosis of chronic obstructive pulmonary disease (COPD) is based on the ratio of forced expiratory volume in 1 second (FEV1)/vital capacity (VC), either as a fixed value 1/VC ratio in a general population setting. The second aim was to evaluate the characteristics of subjects with COPD who obtained a higher SVC than FVC. Methods: Subjects (n=1,050) aged 50-64 years were investigated with FEV1, FVC, and SVC after bronchodilation. Global Initiative for Chronic Obstructive Lung Disease (GOLD) COPDFVC was defined as FEV1/FVC VC as FEV1/VC FVC as FEV1/FVC below the LLN, and LLNCOPDVC as FEV1/VC below the LLN using the maximum value of FVC or SVC. Results: Prevalence of GOLDCOPDFVC was 10.0% (95% confidence interval [CI] 8.2-12.0) and the prevalence of LLNCOPDFVC was 9.5% (95% CI 7.8-11.4). When estimates were based on VC, the prevalence became higher; 16.4% (95% CI 14.3-18.9) and 15.6% (95% CI 13.5-17.9) for GOLDCOPDVC and LLNCOPDVC, respectively. The group of additional subjects classified as having COPD based on VC, had lower FEV1, more wheeze and higher residual volume compared to subjects without any COPD. Conclusion: The prevalence of COPD was significantly higher when the ratio FEV1/VC was calculated using the highest value of SVC or FVC compared with using FVC only. Subjects classified as having COPD when using the VC concept were more obstructive and with indications of air trapping. Hence, the use of only FVC when assessing airflow limitation may result in a considerable under diagnosis of subjects with mild COPD.

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Contribution to journal
publication status
published
subject
keywords
Air trapping, Asthma, Epidemiology, General population, Obstructive, Slow vital capacity, Spirometry
in
The International Journal of Chronic Obstructive Pulmonary Disease
volume
11
issue
1
pages
7 pages
publisher
Dove Press
external identifiers
  • scopus:84964965991
  • wos:000375178100001
ISSN
1176-9106
DOI
10.2147/COPD.S104644
language
English
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yes
id
ebee4e69-c4a4-42ca-ae68-c692d3a0aeb3
date added to LUP
2016-06-03 11:15:57
date last changed
2017-09-17 09:16:05
@article{ebee4e69-c4a4-42ca-ae68-c692d3a0aeb3,
  abstract     = {<p>Background: Spirometric diagnosis of chronic obstructive pulmonary disease (COPD) is based on the ratio of forced expiratory volume in 1 second (FEV<sub>1</sub>)/vital capacity (VC), either as a fixed value 1/VC ratio in a general population setting. The second aim was to evaluate the characteristics of subjects with COPD who obtained a higher SVC than FVC. Methods: Subjects (n=1,050) aged 50-64 years were investigated with FEV<sub>1</sub>, FVC, and SVC after bronchodilation. Global Initiative for Chronic Obstructive Lung Disease (GOLD) COPD<sub>FVC</sub> was defined as FEV<sub>1</sub>/FVC VC as FEV<sub>1</sub>/VC FVC as FEV<sub>1</sub>/FVC below the LLN, and LLNCOPD<sub>VC</sub> as FEV<sub>1</sub>/VC below the LLN using the maximum value of FVC or SVC. Results: Prevalence of GOLDCOPD<sub>FVC</sub> was 10.0% (95% confidence interval [CI] 8.2-12.0) and the prevalence of LLNCOPD<sub>FVC</sub> was 9.5% (95% CI 7.8-11.4). When estimates were based on VC, the prevalence became higher; 16.4% (95% CI 14.3-18.9) and 15.6% (95% CI 13.5-17.9) for GOLDCOPD<sub>VC</sub> and LLNCOPD<sub>VC</sub>, respectively. The group of additional subjects classified as having COPD based on VC, had lower FEV<sub>1</sub>, more wheeze and higher residual volume compared to subjects without any COPD. Conclusion: The prevalence of COPD was significantly higher when the ratio FEV<sub>1</sub>/VC was calculated using the highest value of SVC or FVC compared with using FVC only. Subjects classified as having COPD when using the VC concept were more obstructive and with indications of air trapping. Hence, the use of only FVC when assessing airflow limitation may result in a considerable under diagnosis of subjects with mild COPD.</p>},
  author       = {Torén, Kjell and Olin, Anna Carin and Lindberg, Anne and Vikgren, Jenny and Schiöler, Linus and Brandberg, John and Johnsson, Åse and Engström, Gunnar and Persson, H. Lennart and Sköld, Magnus and Hedner, Jan and Lindberg, Eva and Malinovschi, Andrei and Piitulainen, Eeva and Wollmer, Per and Rosengren, Annika and Janson, Christer and Blomberg, Anders and Bergström, Göran},
  issn         = {1176-9106},
  keyword      = {Air trapping,Asthma,Epidemiology,General population,Obstructive,Slow vital capacity,Spirometry},
  language     = {eng},
  month        = {05},
  number       = {1},
  pages        = {927--933},
  publisher    = {Dove Press},
  series       = {The International Journal of Chronic Obstructive Pulmonary Disease},
  title        = {Vital capacity and COPD : The Swedish CArdioPulmonary bioImage Study (SCAPIS)},
  url          = {http://dx.doi.org/10.2147/COPD.S104644},
  volume       = {11},
  year         = {2016},
}