Maximal mid-expiratory flow detects early lung disease in α1-antitrypsin deficiency

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Maximal mid-expiratory flow detects early lung disease in α1-antitrypsin deficiency. / Stockley, James; Ismail, Asem M; Hughes, Siân M; Edgar, Ross; Stockley, Robert A; Sapey, Elizabeth.

In: The European respiratory journal, Vol. 49, No. 3, 1602055, 01.03.2017.

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Stockley, James ; Ismail, Asem M ; Hughes, Siân M ; Edgar, Ross ; Stockley, Robert A ; Sapey, Elizabeth. / Maximal mid-expiratory flow detects early lung disease in α1-antitrypsin deficiency. In: The European respiratory journal. 2017 ; Vol. 49, No. 3.

Bibtex

@article{b645acd055214475a622d7f98f2f700d,
title = "Maximal mid-expiratory flow detects early lung disease in α1-antitrypsin deficiency",
abstract = "Pathological studies suggest that loss of small airways precedes airflow obstruction and emphysema in chronic obstructive pulmonary disease (COPD). Not all α1-antitrypsin deficiency (AATD) patients develop COPD, and measures of small airways function might be able to detect those at risk. Maximal mid-expiratory flow (MMEF), forced expiratory volume in 1 s (FEV1), ratio of FEV1/forced vital capacity (FVC), health status, presence of emphysema (computed tomography (CT) densitometry) and subsequent decline in FEV1 were assessed in 196 AATD patients. FEV1/FVC, FEV1 % predicted and lung densitometry related to MMEF % pred (r2=0.778, p<0.0001; r2=0.787, p<0.0001; r2=0.594, p<0.0001, respectively) in a curvilinear fashion. Patients could be divided into those with normal FEV1/FVC and MMEF (group 1), normal FEV1/FVC and reduced MMEF (group 2) and those with spirometrically defined COPD (group 3). Patients in group 2 had worse health status than group 1 (median total St George{\textquoteright}s Respiratory Questionnaire (SGRQ) 23.15 (interquartile range (IQR) 7.09–39.63) versus 9.67 (IQR 1.83–22.35); p=0.006) and had a greater subsequent decline in FEV1 (median change in FEV1 −1.09% pred per year (IQR −1.91–0.04% pred per year) versus −0.04% pred per year (IQR −0.67–0.03% pred per year); p=0.007). A reduction in MMEF is an early feature of lung disease in AATD and is associated with impaired health status and a faster decline in FEV1.",
author = "James Stockley and Ismail, {Asem M} and Hughes, {Si{\^a}n M} and Ross Edgar and Stockley, {Robert A} and Elizabeth Sapey",
note = "Copyright {\textcopyright}ERS 2017.",
year = "2017",
month = mar,
day = "1",
doi = "10.1183/13993003.02055-2016",
language = "English",
volume = "49",
journal = "The European respiratory journal",
issn = "0903-1936",
publisher = "European Respiratory Society",
number = "3",

}

RIS

TY - JOUR

T1 - Maximal mid-expiratory flow detects early lung disease in α1-antitrypsin deficiency

AU - Stockley, James

AU - Ismail, Asem M

AU - Hughes, Siân M

AU - Edgar, Ross

AU - Stockley, Robert A

AU - Sapey, Elizabeth

N1 - Copyright ©ERS 2017.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Pathological studies suggest that loss of small airways precedes airflow obstruction and emphysema in chronic obstructive pulmonary disease (COPD). Not all α1-antitrypsin deficiency (AATD) patients develop COPD, and measures of small airways function might be able to detect those at risk. Maximal mid-expiratory flow (MMEF), forced expiratory volume in 1 s (FEV1), ratio of FEV1/forced vital capacity (FVC), health status, presence of emphysema (computed tomography (CT) densitometry) and subsequent decline in FEV1 were assessed in 196 AATD patients. FEV1/FVC, FEV1 % predicted and lung densitometry related to MMEF % pred (r2=0.778, p<0.0001; r2=0.787, p<0.0001; r2=0.594, p<0.0001, respectively) in a curvilinear fashion. Patients could be divided into those with normal FEV1/FVC and MMEF (group 1), normal FEV1/FVC and reduced MMEF (group 2) and those with spirometrically defined COPD (group 3). Patients in group 2 had worse health status than group 1 (median total St George’s Respiratory Questionnaire (SGRQ) 23.15 (interquartile range (IQR) 7.09–39.63) versus 9.67 (IQR 1.83–22.35); p=0.006) and had a greater subsequent decline in FEV1 (median change in FEV1 −1.09% pred per year (IQR −1.91–0.04% pred per year) versus −0.04% pred per year (IQR −0.67–0.03% pred per year); p=0.007). A reduction in MMEF is an early feature of lung disease in AATD and is associated with impaired health status and a faster decline in FEV1.

AB - Pathological studies suggest that loss of small airways precedes airflow obstruction and emphysema in chronic obstructive pulmonary disease (COPD). Not all α1-antitrypsin deficiency (AATD) patients develop COPD, and measures of small airways function might be able to detect those at risk. Maximal mid-expiratory flow (MMEF), forced expiratory volume in 1 s (FEV1), ratio of FEV1/forced vital capacity (FVC), health status, presence of emphysema (computed tomography (CT) densitometry) and subsequent decline in FEV1 were assessed in 196 AATD patients. FEV1/FVC, FEV1 % predicted and lung densitometry related to MMEF % pred (r2=0.778, p<0.0001; r2=0.787, p<0.0001; r2=0.594, p<0.0001, respectively) in a curvilinear fashion. Patients could be divided into those with normal FEV1/FVC and MMEF (group 1), normal FEV1/FVC and reduced MMEF (group 2) and those with spirometrically defined COPD (group 3). Patients in group 2 had worse health status than group 1 (median total St George’s Respiratory Questionnaire (SGRQ) 23.15 (interquartile range (IQR) 7.09–39.63) versus 9.67 (IQR 1.83–22.35); p=0.006) and had a greater subsequent decline in FEV1 (median change in FEV1 −1.09% pred per year (IQR −1.91–0.04% pred per year) versus −0.04% pred per year (IQR −0.67–0.03% pred per year); p=0.007). A reduction in MMEF is an early feature of lung disease in AATD and is associated with impaired health status and a faster decline in FEV1.

UR - http://www.scopus.com/inward/record.url?scp=85030173289&partnerID=8YFLogxK

U2 - 10.1183/13993003.02055-2016

DO - 10.1183/13993003.02055-2016

M3 - Article

C2 - 28356373

VL - 49

JO - The European respiratory journal

JF - The European respiratory journal

SN - 0903-1936

IS - 3

M1 - 1602055

ER -