Comparison of FEV1/FEV6 with FEV1/FVC in the diagnosis of COPD
DOI:
https://doi.org/10.18203/2349-3933.ijam20174109Keywords:
COPD, FEV1/FEV6 ratio, Risk factorsAbstract
Background: Globally COPD occurs. But it is a health hazard among those who smoke. The life expectancy is also reduced to a large extent. Hence early diagnosis may help prevent further progression of disease and motivate people to modify their lifestyle.
Methods: Patients aged 40 years and above, attending to pulmonology OPD and in-patients with symptoms suggestive of COPD were subjected to spirometric examinations following standard protocol of test performance as laid down by ATS/ERS. Spirometric examinations were analyzed statistically to know the performance of FEV1/FEV6 ratio using a cut-off value of < 0.70 (post bronchodilator) arbitrarily as against FEV1/FVC ratio of < 0.70 (post bronchodilator) in accordance with GOLD guidelines for the diagnosis of COPD.
Results: Majority (83.8%) were male. Out of 229 patients 197 patients had airways obstruction as per post bronchodilator FEV1/FVC of < 0.70. Among 197 patients who were diagnosed as having COPD as per post bronchodilator FEV1/FVC ratio, 180 (91.37%) patients had an FEV1/FEV6 value < 0.70. Among 192 male patients, 170 were diagnosed as having COPD as per post bronchodilator FEV1/FVC ratio of < 0.70 as against 153 as per post bronchodilator FEV1/FEV6 ratio of < 0.70. Among 37 female patients 27 were found to have COPD based on both FEV1/FVC and FEV1/FEV6 post bronchodilator values.
Conclusions: FEV1/FEV6 ratio is an acceptable alternative to FEV1/FVC ratio in the diagnosis of COPD in patients aged 40 years and above and with risk factors for COPD.
References
Fletcher CM, Tinker CM, Peto R, Speizer FE. The natural history of chronic bronchitis and emphysema. Oxford. Oxford University Press; 1976.
Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004;23:932-46.
Salvi S. COPD, The neglected epidemic. In: Jindal SK, editor. Textbook of Pulmonary and Critical Care Medicine, Vol 2, 1st ed. Jaypee Publications: New Delhi. 2011;971-974.
The Global Burden of Disease, WHO 2008 Oct. Available at www.who.int/healthinfo /global burden_disease/projections/en/index.html.
Reddy KS, Gupta PC. Report on tobacco control in India. New Delhi: Ministry of Health and Family Welfare, Government of India; 2004:99-102.
Pande JN, Khilnani GC. Epidemiology and etiology. In: Shankar PS, editor. Chronic obstructive pulmonary disease. Mumbai: Indian College of Physicians; 1997:10-22.
Nigam P, Verma BL, Srivastava RN. Chronic bronchitis in an Indian rural community. J Assoc Physicians India. 1982;30:277-80.
Thiruvengadam KV, Raghava TP, Bhardwaj KV. Survey of prevalence of chronic bronchitis in Madras city. In: Viswanath R, Jaggi OP, editors. Advances in chronic obstructive lung disease. Delhi: Asthma and Bronchitis Foundation of India; 1977:59-69.
Rabe KF, Hurd S, Anzueto A. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2007;176:532-55.
Lopez AD, Shibuya K, Rao C. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J. 2006;27:397-412.
Halbert RJ, Isonaka S, George D. Interpreting COPD prevalence estimates: what is the true burden of disease? Chest. 2003;123:1684-92.
Enright PL, Kaminsky DA. Strategies for screening for chronic obstructive pulmonary disease. Respir Care. 2003;48:1194-201.
Bellia V, Sorino C, Catalano F. Validation of FEV6 in the elderly: correlates of performance and repeatability. Thorax. 2008;63:60-6.
Glindmeyer HW, Jones RN, Barkman HW. Spirometry: quantitative test criteria and test acceptability. Am Rev Respir Dis. 1987;136:449-52.
Ferguson GT, Enright PL, Buist AS, Higgins MW. Office spirometry for lung health assessment in adults: a consensus statement from the National Lung Health Education Program. Chest. 2000;117:1146-61.
Swanney MP, Jensen RL, Crichton DA. FEV6 is an acceptable surrogate for FVC in the spirometric diagnosis of airway obstruction and restriction. Am J Respir Crit Care Med. 2000;162:917-9.
Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD), 2011. Available at http:// www.goldcopd.org/.
Medical section of the American Lung Association. Lung Function Testing: selection of reference values and interpretative strategies. Am Rev Respir Dis. 1991;144:1202-18.
Pellegrino R, Viegi G, Brusasco V, Crapo R, Burgos F, Casaburi R. Interpretative strategies for lung function tests. Eur Respir J. 2005;26:948-68.
Melbye H, Medbo A, Crockett A. The FEV1/FEV6 ratio is a good substitute for the FEV1/FVC ratio in the elderly. Prim Care Respir J. 2006;15:294-8.
Rosa FW, Perez-Padilla R, Camelier A. Efficacy of the FEV1/FEV6 ratio compared to the FEV1/FVC ratio for the diagnosis of airway obstruction in subjects aged 40 years or over. Braz J Med Biol Res. 2007;40:1615-21.
Vandevoorde J, Verbanck S, Schuermans D, Kartounian J, Vincken W. Obstructive and restrictive spirometric patterns: fixed cut-offs for FEV1/FEV6 and FEV6. Eur Respir J. 2006;27:378-83.
Akpinar-Elci M, Fedan KB, Enright PL. FEV6 as a surrogate for FVC in detecting airways obstruction and restriction in the workplace. Eur Respir J. 2006;27:374-7.
