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June 3, 2020 / in Scientific Article

Abstract

We’ve shown FOT staged COPD correlates better with patient reported outcomes (PROs) than spirometry (SP) staged COPD. We hypothesized non-obstructed subjects (non-OB, FEV1/FVC≥0.7) with either MMEF<65% predicted or RV>130% predicted would be more similar to obstructed subjects (OB, FEV1/FVC<0.7) in the presence of ventilator inhomogeneity (VI, A<X>9 cmH2O/L/s) by FOT. 300 COPD subjects (>10 pack-year smoking and either FEV1/FVC<0.7, MMEF<65%predicted or RV>130%predicted) had PROs (mMRC, COPD Assessment Tests, chronic bronchitis questionnaires and AERs), PFTs (Jaeger or Vmax22, Carefusion, Germany), FOT (tremoFlo C-100, Thorasys, Canada) and in a subset, quantitative CT scan lung density (LD) abstracted from charts. Subjects were assigned to 1 of 4 groups based on FEV1/FVC≥/<0.7 and A<X>/≤9. Differences between continuous variables were determined with ANOVA and dichotomous with χ2. Significance was set at p<0.05 after Bonferroni correction. Subjects were more similar when partitioned by FOT than by SP in terms of CAT, mMRC, chronic bronchitis and emphysema (LD<55g/L) but not AER (Table 1).

While concordant phenotypes of non-VI/non-OB and VI/OB had a clear separation of disease burden in terms of PROs and emphysema, the discordant phenotypes of VI/non-OB and non-VI/OB resembled more their VI status than their OB status. Our data suggests that up to 19% of COPD subjects may be misclassified using SP.

The articles include uses of tremoflo products or describes research devices that may not have been cleared by FDA
Source

Dandurand R, Dandurand M, Estépar RSJ, Bourbeau J, Eidelman D. Discordant and concordant FOT-spirometry phenotypes in a COPD population. Eur Respir J. 2017;50:PA4533.

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