Publication:
A new bronchodilator response grading strategy ıdentifies distinct patient populations

dc.contributor.authorHansen, James E.
dc.contributor.authorPorszasz, Janos
dc.contributor.authorStringer, William W.
dc.contributor.authorPak, Youngju
dc.contributor.authorRossiter, Harry B.
dc.contributor.authorCasaburi, Richard
dc.contributor.buuauthorDilektaşlı, Aslı G.
dc.contributor.departmentTıp Fakültesi
dc.contributor.departmentDahili Tıp Bilimleri
dc.contributor.departmentGöğüs Hastalıkları Bölümü
dc.contributor.orcid0000-0001-7099-9647tr_TR
dc.contributor.scopusid36466376600tr_TR
dc.date.accessioned2023-06-15T13:34:42Z
dc.date.available2023-06-15T13:34:42Z
dc.date.issued2019-12
dc.description.abstractRationale: A positive bronchodilator response (BDR) according to American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines require both 200 ml and 12% increase in forced expiratory volume in 1 second (FEV1) or forced vital capacity (FVC) after bronchodilator inhalation. This dual criterion is insensitive in those with high or low FEV1. Objectives: To establish BDR criteria with volume or percentage FEV1 change. Methods: The largest FEV1 and FVC were identified fromthree pre- and three post-bronchodilator maneuvers in COPDGene (Genetic Epidemiology of COPD) participants. A total of 7,741 individuals with coefficient of variation less than 15% for both FEV1 and FVC formed bronchodilator categories of FEV1 response: negative (<= 0.00% or <= 0.00 L), minimal (>0.00% to <= 9.00% or >0.00 L to <= 0.09 L), mild (>9.00% to <= 16.00% or.0.09 L to <0.16 L), moderate (>16.00% to <= 26.00% or >0.16 L to <= 0.26 L), and marked (>26.00% or >0.26 L). These response size categories are based on empirical limits considering average FEV1 increase of approximately 160 ml and the clinically important difference for FEV1. To compare flow and volume response characteristics, BDR-FEV1 category assignments were applied for the BDR-FVC response. Results: Twenty percent met mild and 31% met moderate or marked BDR-FEV1 criteria, whereas 12% met mild and 33% met moderate or marked BDR-FVC criteria. In contrast, only 20.6% met ATS/ERS positive criteria. Compared with the negative BDR-FEV1 category, the minimal, mild, moderate, and marked BDR-FEV1 categories were associated with greater 6-minute-walk distance and lower St. George's Respiratory Questionnaire and modified Medical Research Council dyspnea scale scores. Compared with negative BDR, moderate and marked BDR-FEV1 categories were associated with fewer exacerbations, and minimal BDR was associated with lower computed tomography airway wall thickness. Compared with the negative category, all BDR-FVC categories were associated with increasing emphysema percentage and gas trapping percentage. Moderate and marked BDR-FVC categories were associated with higher St. George's Respiratory Questionnaire scores but fewer exacerbations and lower dyspnea scores. Conclusions: BDR grading by FEV1 volume or percentage response identified subjects otherwise missed by ATS/ERS criteria. BDR grades were associated with functional exercise performance, quality of life, exacerbation frequency, dyspnea, and radiological airway measures. BDR grades in FEV1 and FVC indicate different clinical and radiological characteristics.en_US
dc.description.sponsorshipUnited States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Heart Lung & Blood Institute (NHLBI)en_US
dc.description.sponsorshipNational Center for Advancing Translational Sciences through UCLA CTSI Granten_US
dc.identifier.citationHansen, J. E. vd. (2019). ''A new bronchodilator response grading strategy ıdentifies distinct patient populations''. Annals of the American Thoracic Society, 16(12), 1504-1517.en_US
dc.identifier.endpage1517tr_TR
dc.identifier.issn1546-3222
dc.identifier.issn2325-6621
dc.identifier.issue12tr_TR
dc.identifier.pubmed31404502tr_TR
dc.identifier.scopus2-s2.0-85075774981tr_TR
dc.identifier.startpage1504tr_TR
dc.identifier.urihttps://doi.org/10.1513/AnnalsATS.201901-030OC
dc.identifier.urihttps://www.atsjournals.org/doi/10.1513/AnnalsATS.201901-030OC
dc.identifier.urihttp://hdl.handle.net/11452/33051
dc.identifier.volume16tr_TR
dc.identifier.wos000499727700010
dc.indexed.pubmedPubMeden_US
dc.indexed.scopusScopusen_US
dc.indexed.wosSCIEen_US
dc.language.isoenen_US
dc.publisherAmer Thoracicen_US
dc.relation.collaborationYurt dışıtr_TR
dc.relation.collaborationSanayitr_TR
dc.relation.journalAnnals of the American Thoracic Societyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergitr_TR
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAirflow obstructionen_US
dc.subjectRespiratory Systemen_US
dc.subjectBronchodilator responsivenessen_US
dc.subjectForced expiratory volume in 1 seconden_US
dc.subjectComputed-tomographyen_US
dc.subjectAirway-obstructionen_US
dc.subjectOverlap syndromeen_US
dc.subjectReversibilityen_US
dc.subjectResponsivenessen_US
dc.subjectCopden_US
dc.subjectFvcen_US
dc.subjectFev1en_US
dc.subjectVariabilityen_US
dc.subjectDiagnosisen_US
dc.subject.emtreeBeta 2 adrenergic receptor stimulating agenten_US
dc.subject.emtreeSalbutamolen_US
dc.subject.emtreeBronchodilating agenten_US
dc.subject.emtreeAdulten_US
dc.subject.emtreeAirway obstructionen_US
dc.subject.emtreeAirway remodelingen_US
dc.subject.emtreeAmerican Thoracic Society European Respiratory Society criteriaen_US
dc.subject.emtreeArticleen_US
dc.subject.emtreeBronchodilator response grading strategyen_US
dc.subject.emtreeChronic obstructive lung diseaseen_US
dc.subject.emtreeCohort analysisen_US
dc.subject.emtreeComparative studyen_US
dc.subject.emtreeComputer assisted tomographyen_US
dc.subject.emtreeControlled studyen_US
dc.subject.emtreeCurrent smokeren_US
dc.subject.emtreeDisease exacerbationen_US
dc.subject.emtreeDyspneaen_US
dc.subject.emtreeEx-smokeren_US
dc.subject.emtreeExerciseen_US
dc.subject.emtreeFemaleen_US
dc.subject.emtreeForced expiratory volumeen_US
dc.subject.emtreeForced vital capacityen_US
dc.subject.emtreeFunctional statusen_US
dc.subject.emtreeHumanen_US
dc.subject.emtreeLung emphysemaen_US
dc.subject.emtreeLung volumeen_US
dc.subject.emtreeMajor clinical studyen_US
dc.subject.emtreeMaleen_US
dc.subject.emtreeMiddle ageden_US
dc.subject.emtreeModified medical research council dyspnea scaleen_US
dc.subject.emtreeMorbidityen_US
dc.subject.emtreePractice guidelineen_US
dc.subject.emtreeQuality of lifeen_US
dc.subject.emtreeRespiratory tract disease assessmenten_US
dc.subject.emtreeSix minute walk testen_US
dc.subject.emtreeSt. George respiratory questionnaireen_US
dc.subject.emtreeAgeden_US
dc.subject.emtreeChronic obstructive lung diseaseen_US
dc.subject.emtreeClinical trialen_US
dc.subject.emtreeForced expiratory volumeen_US
dc.subject.emtreeLung function testen_US
dc.subject.emtreeMulticenter studyen_US
dc.subject.emtreePathophysiologyen_US
dc.subject.emtreeQuestionnaireen_US
dc.subject.emtreeSeverity of illness indexen_US
dc.subject.emtreeSpirometryen_US
dc.subject.emtreeStatistical modelen_US
dc.subject.emtreeVital capacityen_US
dc.subject.emtreeX-ray computed tomographyen_US
dc.subject.meshAgeden_US
dc.subject.meshBronchodilator agentsen_US
dc.subject.meshFemaleen_US
dc.subject.meshForced expiratory volumeen_US
dc.subject.meshHumansen_US
dc.subject.meshLinear modelsen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle ageden_US
dc.subject.meshPulmonary disease, chronic obstructiveen_US
dc.subject.meshQuality of lifeen_US
dc.subject.meshRespiratory function testsen_US
dc.subject.meshSeverity of illness indexen_US
dc.subject.meshSpirometryen_US
dc.subject.meshSurveys and questionnairesen_US
dc.subject.meshTomography, X-Ray computeden_US
dc.subject.meshVital capacityen_US
dc.subject.scopusUndifferentiated Connective Tissue Diseases; Adrenal Cortex Hormone; Global Initiativesen_US
dc.subject.wosRespiratory systemen_US
dc.titleA new bronchodilator response grading strategy ıdentifies distinct patient populationsen_US
dc.typeArticle
dc.wos.quartileQ1en_US
dspace.entity.typePublication
local.contributor.departmentTıp Fakültesi/Dahili Tıp Bilimleri/Göğüs Hastalıkları Bölümütr_TR

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