Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is thought to result from an accelerated decline in forced expiratory volume in 1 second (FEV1) over time. Yet it is possible that a normal decline in FEV1 could also lead to COPD in persons whose maximally attained FEV1 is less than populatio...

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Autores: Lange, Peter, Celli, Bartolome R., Agustí García-Navarro, Àlvar, Jensen, Gorm Boje, Divo, Miguel, Faner, Rosa, Guerra, Stefano, Marott, Jacob Louis, Martínez, Fernando D., Martínez Camblor, Pablo, Meek, Paula, Owen, Caroline A., Petersen, Hans, Pinto-Plata, Victor M., Schnohr, Peter, Sood, Akshay, Soriano, Joan B., Testafaigzi, Yohannes, Vestbo, Jørgen
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2015
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/105922
Acceso en línea:https://hdl.handle.net/2445/105922
Access Level:acceso abierto
Palabra clave:Malalties pulmonars obstructives cròniques
Pulmó
Malalties de l'aparell respiratori
Chronic obstructive pulmonary diseases
Lung
Respiratory organs diseases
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spelling Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary DiseaseLange, PeterCelli, Bartolome R.Agustí García-Navarro, ÀlvarJensen, Gorm BojeDivo, MiguelFaner, RosaGuerra, StefanoMarott, Jacob LouisMartínez, Fernando D.Martínez Camblor, PabloMeek, PaulaOwen, Caroline A.Petersen, HansPinto-Plata, Victor M.Schnohr, PeterSood, AkshaySoriano, Joan B.Testafaigzi, YohannesVestbo, JørgenMalalties pulmonars obstructives cròniquesPulmóMalalties de l'aparell respiratoriChronic obstructive pulmonary diseasesLungRespiratory organs diseasesBACKGROUND: Chronic obstructive pulmonary disease (COPD) is thought to result from an accelerated decline in forced expiratory volume in 1 second (FEV1) over time. Yet it is possible that a normal decline in FEV1 could also lead to COPD in persons whose maximally attained FEV1 is less than population norms. METHODS: We stratified participants in three independent cohorts (the Framingham Offspring Cohort, the Copenhagen City Heart Study, and the Lovelace Smokers Cohort) according to lung function (FEV1 ≥80% or <80% of the predicted value) at cohort inception (mean age of patients, approximately 40 years) and the presence or absence of COPD at the last study visit. We then determined the rate of decline in FEV1 over time among the participants according to their FEV1 at cohort inception and COPD status at study end. RESULTS: Among 657 persons who had an FEV1 of less than 80% of the predicted value before 40 years of age, 174 (26%) had COPD after 22 years of observation, whereas among 2207 persons who had a baseline FEV1 of at least 80% of the predicted value before 40 years of age, 158 (7%) had COPD after 22 years of observation (P<0.001). Approximately half the 332 persons with COPD at the end of the observation period had had a normal FEV1 before 40 years of age and had a rapid decline in FEV1 thereafter, with a mean (±SD) decline of 53±21 ml per year. The remaining half had had a low FEV1 in early adulthood and a subsequent mean decline in FEV1 of 27±18 ml per year (P<0.001), despite similar smoking exposure. CONCLUSIONS: Our study suggests that low FEV1 in early adulthood is important in the genesis of COPD and that accelerated decline in FEV1 is not an obligate feature of COPD. (Funded by an unrestricted grant from GlaxoSmithKline and others.).Massachusetts Medical Society2015info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/105922Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1056/NEJMoa1411532New England Journal of Medicine, 2015, vol. 373, num. 2, p. 111-122https://doi.org/10.1056/NEJMoa1411532(c) Massachusetts Medical Society, 2015info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1059222026-05-27T06:46:51Z
dc.title.none.fl_str_mv Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease
title Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease
spellingShingle Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease
Lange, Peter
Malalties pulmonars obstructives cròniques
Pulmó
Malalties de l'aparell respiratori
Chronic obstructive pulmonary diseases
Lung
Respiratory organs diseases
title_short Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease
title_full Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease
title_fullStr Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease
title_full_unstemmed Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease
title_sort Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease
dc.creator.none.fl_str_mv Lange, Peter
Celli, Bartolome R.
Agustí García-Navarro, Àlvar
Jensen, Gorm Boje
Divo, Miguel
Faner, Rosa
Guerra, Stefano
Marott, Jacob Louis
Martínez, Fernando D.
Martínez Camblor, Pablo
Meek, Paula
Owen, Caroline A.
Petersen, Hans
Pinto-Plata, Victor M.
Schnohr, Peter
Sood, Akshay
Soriano, Joan B.
Testafaigzi, Yohannes
Vestbo, Jørgen
author Lange, Peter
author_facet Lange, Peter
Celli, Bartolome R.
Agustí García-Navarro, Àlvar
Jensen, Gorm Boje
Divo, Miguel
Faner, Rosa
Guerra, Stefano
Marott, Jacob Louis
Martínez, Fernando D.
Martínez Camblor, Pablo
Meek, Paula
Owen, Caroline A.
Petersen, Hans
Pinto-Plata, Victor M.
Schnohr, Peter
Sood, Akshay
Soriano, Joan B.
Testafaigzi, Yohannes
Vestbo, Jørgen
author_role author
author2 Celli, Bartolome R.
Agustí García-Navarro, Àlvar
Jensen, Gorm Boje
Divo, Miguel
Faner, Rosa
Guerra, Stefano
Marott, Jacob Louis
Martínez, Fernando D.
Martínez Camblor, Pablo
Meek, Paula
Owen, Caroline A.
Petersen, Hans
Pinto-Plata, Victor M.
Schnohr, Peter
Sood, Akshay
Soriano, Joan B.
Testafaigzi, Yohannes
Vestbo, Jørgen
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Malalties pulmonars obstructives cròniques
Pulmó
Malalties de l'aparell respiratori
Chronic obstructive pulmonary diseases
Lung
Respiratory organs diseases
topic Malalties pulmonars obstructives cròniques
Pulmó
Malalties de l'aparell respiratori
Chronic obstructive pulmonary diseases
Lung
Respiratory organs diseases
description BACKGROUND: Chronic obstructive pulmonary disease (COPD) is thought to result from an accelerated decline in forced expiratory volume in 1 second (FEV1) over time. Yet it is possible that a normal decline in FEV1 could also lead to COPD in persons whose maximally attained FEV1 is less than population norms. METHODS: We stratified participants in three independent cohorts (the Framingham Offspring Cohort, the Copenhagen City Heart Study, and the Lovelace Smokers Cohort) according to lung function (FEV1 ≥80% or <80% of the predicted value) at cohort inception (mean age of patients, approximately 40 years) and the presence or absence of COPD at the last study visit. We then determined the rate of decline in FEV1 over time among the participants according to their FEV1 at cohort inception and COPD status at study end. RESULTS: Among 657 persons who had an FEV1 of less than 80% of the predicted value before 40 years of age, 174 (26%) had COPD after 22 years of observation, whereas among 2207 persons who had a baseline FEV1 of at least 80% of the predicted value before 40 years of age, 158 (7%) had COPD after 22 years of observation (P<0.001). Approximately half the 332 persons with COPD at the end of the observation period had had a normal FEV1 before 40 years of age and had a rapid decline in FEV1 thereafter, with a mean (±SD) decline of 53±21 ml per year. The remaining half had had a low FEV1 in early adulthood and a subsequent mean decline in FEV1 of 27±18 ml per year (P<0.001), despite similar smoking exposure. CONCLUSIONS: Our study suggests that low FEV1 in early adulthood is important in the genesis of COPD and that accelerated decline in FEV1 is not an obligate feature of COPD. (Funded by an unrestricted grant from GlaxoSmithKline and others.).
publishDate 2015
dc.date.none.fl_str_mv 2015
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/105922
url https://hdl.handle.net/2445/105922
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1056/NEJMoa1411532
New England Journal of Medicine, 2015, vol. 373, num. 2, p. 111-122
https://doi.org/10.1056/NEJMoa1411532
dc.rights.none.fl_str_mv (c) Massachusetts Medical Society, 2015
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Massachusetts Medical Society, 2015
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Massachusetts Medical Society
publisher.none.fl_str_mv Massachusetts Medical Society
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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