Clinical Significance of Symptoms in Smokers with Preserved Pulmonary Function

• Published in: The New England journal of medicine Vol. 374; no. 19; pp. 1811 - 1821
• Main Authors: Woodruff, Prescott G, Barr, R. Graham, Bleecker, Eugene, Christenson, Stephanie A, Couper, David, Curtis, Jeffrey L, Gouskova, Natalia A, Hansel, Nadia N, Hoffman, Eric A, Kanner, Richard E, Kleerup, Eric, Lazarus, Stephen C, Martinez, Fernando J, Paine, Robert, Rennard, Stephen, Tashkin, Donald P, Han, MeiLan K
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 12.05.2016
• Subjects: Adult; Aged; Aged, 80 and over; Asthma; Asthma - complications; Bronchodilator Agents - therapeutic use; Bronchodilators; Chronic obstructive pulmonary disease; Clinical significance; Computed tomography; Confounding Factors, Epidemiologic; Emphysema; Female; Forced Expiratory Volume; Glucocorticoids; Humans; Lung - diagnostic imaging; Lung - physiology; Lung diseases; Male; Medical diagnosis; Middle Aged; Obstructive lung disease; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - physiopathology; Respiration; Respiratory function; Respiratory tract diseases; Smoking; Smoking - physiopathology; Symptom Assessment; Tomography, X-Ray Computed; Vital Capacity; United States > US; San Francisco California
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa1505971

Chronic obstructive pulmonary disease diagnosis rests on chronic pulmonary symptoms and airflow obstruction. This study showed that people may have chronic COPD symptoms but no airflow obstruction. Such patients have more COPD exacerbations than those without chronic symptoms. Among the criteria that are needed to make a diagnosis of chronic obstructive pulmonary disease (COPD) are deficits in the rate at which one can forcefully exhale. Most experts consider a low ratio (<0.70) of the forced expiratory volume in 1 second (FEV 1 ) to the forced vital capacity (FVC) after bronchodilator use to be a key diagnostic criterion. 1 Once the diagnosis of COPD has been established, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) nomenclature grades severity according to the degree to which the measured FEV 1 is lower than the patient’s predicted value. GOLD stage 1, . . .