PMID- 28144365
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1874-3064 (Print)
IS  - 1874-3064 (Electronic)
IS  - 1874-3064 (Linking)
VI  - 10
DP  - 2016
TI  - Predicted Values for Spirometry may Underestimate Long-Standing Asthma Severity.
PG  - 70-78
LID - 10.2174/1874306401610010070 [doi]
AB  - BACKGROUND: Asthma may show an accelerated lung function decline. Asthmatics, 
      although having FEV(1) and FEV(1)/VC (and z-scores) higher than the lower limit 
      of normality, may show a significant FEV(1) decline when compared to previous 
      measurements. We assessed how many asymptomatic long-standing asthmatics (LSA) 
      with normal lung function showed a significant FEV(1) decline when an older 
      FEV(1) was taken as reference point. METHODS: 46 well-controlled LSA (age: 
      48.8+/-12.1; 23 females) with normal FEV(1) and FEV(1)/VC according to GLI2012 
      references (FEV(1): 94.8+/-10.1%, z-score:-0.38+/-0.79; FEV(1)/VC: 79.3+/-5.2, 
      z-score:-0.15+/-0.77) were selected. We considered FEV(1) decline, calculated by 
      comparing the latest value to one at least five years older or to the highest 
      predicted value measured at 21 years for females and 23 for males. A FEV(1) 
      decline >15% or 30 ml/years was regarded as pathological. RESULTS: When comparing 
      the latest FEV(1) to an at least 5-year-older one (mean 8.1+/-1.4 years between 2 
      measurements), 14 subjects (30.4%) showed a FEV(1) decline <5% (mean: -2.2+/-2.6%), 
      19 (41.3%) had a FEV(1) 5-15% change (mean: -9.2+/-2.5%) and 13 (28.3%) a FEV(1) 
      decrease>15% (mean: -18.3+/-2.4). Subjects with a FEV(1) decline>30 ml/year were 28 
      (60.8%). When using the highest predicted FEV(1) as reference point and declines 
      were corrected by subtracting the physiological decrease, 6 (13%) patients showed 
      a FEV(1) decline higher than 15%, whereas asthmatics with a FEV(1) loss>30 
      ml/year were 17 (37%). CONCLUSION: FEV(1) decline calculation may show how severe 
      asthma actually is, avoiding a bronchial obstruction underestimation and a 
      possible under-treatment in lots of apparent "well-controlled" LSA with 
      GLI2012-normal-range lung function values.
FAU - Sposato, Bruno
AU  - Sposato B
AD  - Unit of Pneumology, "Misericordia" Hospital, Grosseto, Italy.
LA  - eng
PT  - Journal Article
DEP - 20161130
PL  - United Arab Emirates
TA  - Open Respir Med J
JT  - The open respiratory medicine journal
JID - 101480481
PMC - PMC5220173
OTO - NOTNLM
OT  - Asthma
OT  - FEV1 decline
OT  - Lung function
OT  - Reference values
OT  - Spirometry
EDAT- 2017/02/02 06:00
MHDA- 2017/02/02 06:01
PMCR- 2016/01/01
CRDT- 2017/02/02 06:00
PHST- 2016/06/22 00:00 [received]
PHST- 2016/11/14 00:00 [revised]
PHST- 2016/11/14 00:00 [accepted]
PHST- 2017/02/02 06:00 [entrez]
PHST- 2017/02/02 06:00 [pubmed]
PHST- 2017/02/02 06:01 [medline]
PHST- 2016/01/01 00:00 [pmc-release]
AID - TORMJ-10-70 [pii]
AID - 10.2174/1874306401610010070 [doi]
PST - epublish
SO  - Open Respir Med J. 2016 Nov 30;10:70-78. doi: 10.2174/1874306401610010070. 
      eCollection 2016.