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Clinical Features of Subjects with Non-Specific Pulmonary Function Test (PFT) Pattern
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A3920 - Clinical Features of Subjects with Non-Specific Pulmonary Function Test (PFT) Pattern
Author Block: A. Z. Rasheed1, L. Latypov2, M. Shahzadi1, V. P. Vasudevan1, L. N. Gerolemou1, F. Arjomand1; 1Pulmonary Medicine, The Brooklyn Hospital Center, Brooklyn, NY, United States, 2Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY, United States.
BACKGROUND: Abnormal pulmonary function test (PFT) patterns are classified as obstructive, restrictive, or mixed. Obstructive pattern is based on spirometric finding of a low FEV1/FVC. The criterion currently considered to be the gold standard for restriction is decreased TLC. The clinical significance of reduction in Forced Expiratory Volume in 1 second (FEV1 ) and or isolated reduction in Vital capacity (low VC) in presence of normal FEV1/FVC (Non-obstructive) and normal TLC (non-restrictive) has not been established. OBJECTIVES: To examine the clinical features of patients with isolated reduction in FEV1 and/or VC. STUDY DESIGN: Retrospective chart review. RESULTS: 62 patients with reduced FEV1 and/or VC were included. Patient with Low TLC , Low FEV1/FVC and with incomplete expiration to end-of-test criteria were excluded. Mean age was 51 years (range 11-85). 38/62 (61%) were females and 24 (39%) were males. 23/62 (37%) had history of smoking. 38 (61%) were Hispanic, 10 (16%) were African American, 8 (13%) were Caucasians. Mean BMI was 35. Reason for obtaining PFT was Asthma 34 (55%), COPD 11(17%), Morbid Obesity 9(15.5 %), ILD 3 (5%), Sarcoidosis 2 (3%), CHF 2 (3%) and chronic cough 1 (1.5%). 34 (55%) had symptoms of shortness of breath or cough. 14 ( 22.5%) were asymptomatic and 14 (22.5%) had no documentations regarding symptoms. 34/62 (55%) were on short acting B-agonist (SABA), 13 (21%) on LABA/ICS, 5 (8%) on ICS and 3 (5%) on montelukast. Radiological studies were available in 33/62 (53%). Out of these 16/33 (48%) had normal parenchyma, 9/33 (27%) fibrotic changes, 4/33 (12%) scoliosis, and 4/33 (12%) had hyperinflation. 57 (92%) had reduced FEV1. Out of these 6/57 (10.5%) had reduced FEV1/SVC. bronchodilator response was performed in 25/62 (40%) of patient and was positive in only 2/25 (8%) patients. 35/62 (56%) had reduced VC. Patients with abnormal imaging including parenchymal scarring and chest wall deformity had universal reduction in FEV1. DISCUSSION: Clinical significance of isolated reductions in FEV1 and/or isolated reduction in VC not been established. In presence of normal FEV1/FVC and normal TLC, these patients do not fall into obstructive or restrictive category. In our study, majority of the patients with non-specific pattern belonged to Hispanic Race. Obese patients tend to have non-specific PFTs findings. Reduction in FEV1 is more sensitive than VC in patients with parenchymal scarring and chest wall abnormalities. Bronchodilator response, increase RV/TLC ratio, reduced FEV1/SVC can help further categorize these patients in obstructive group.
Author Block: A. Z. Rasheed1, L. Latypov2, M. Shahzadi1, V. P. Vasudevan1, L. N. Gerolemou1, F. Arjomand1; 1Pulmonary Medicine, The Brooklyn Hospital Center, Brooklyn, NY, United States, 2Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY, United States.
BACKGROUND: Abnormal pulmonary function test (PFT) patterns are classified as obstructive, restrictive, or mixed. Obstructive pattern is based on spirometric finding of a low FEV1/FVC. The criterion currently considered to be the gold standard for restriction is decreased TLC. The clinical significance of reduction in Forced Expiratory Volume in 1 second (FEV1 ) and or isolated reduction in Vital capacity (low VC) in presence of normal FEV1/FVC (Non-obstructive) and normal TLC (non-restrictive) has not been established. OBJECTIVES: To examine the clinical features of patients with isolated reduction in FEV1 and/or VC. STUDY DESIGN: Retrospective chart review. RESULTS: 62 patients with reduced FEV1 and/or VC were included. Patient with Low TLC , Low FEV1/FVC and with incomplete expiration to end-of-test criteria were excluded. Mean age was 51 years (range 11-85). 38/62 (61%) were females and 24 (39%) were males. 23/62 (37%) had history of smoking. 38 (61%) were Hispanic, 10 (16%) were African American, 8 (13%) were Caucasians. Mean BMI was 35. Reason for obtaining PFT was Asthma 34 (55%), COPD 11(17%), Morbid Obesity 9(15.5 %), ILD 3 (5%), Sarcoidosis 2 (3%), CHF 2 (3%) and chronic cough 1 (1.5%). 34 (55%) had symptoms of shortness of breath or cough. 14 ( 22.5%) were asymptomatic and 14 (22.5%) had no documentations regarding symptoms. 34/62 (55%) were on short acting B-agonist (SABA), 13 (21%) on LABA/ICS, 5 (8%) on ICS and 3 (5%) on montelukast. Radiological studies were available in 33/62 (53%). Out of these 16/33 (48%) had normal parenchyma, 9/33 (27%) fibrotic changes, 4/33 (12%) scoliosis, and 4/33 (12%) had hyperinflation. 57 (92%) had reduced FEV1. Out of these 6/57 (10.5%) had reduced FEV1/SVC. bronchodilator response was performed in 25/62 (40%) of patient and was positive in only 2/25 (8%) patients. 35/62 (56%) had reduced VC. Patients with abnormal imaging including parenchymal scarring and chest wall deformity had universal reduction in FEV1. DISCUSSION: Clinical significance of isolated reductions in FEV1 and/or isolated reduction in VC not been established. In presence of normal FEV1/FVC and normal TLC, these patients do not fall into obstructive or restrictive category. In our study, majority of the patients with non-specific pattern belonged to Hispanic Race. Obese patients tend to have non-specific PFTs findings. Reduction in FEV1 is more sensitive than VC in patients with parenchymal scarring and chest wall abnormalities. Bronchodilator response, increase RV/TLC ratio, reduced FEV1/SVC can help further categorize these patients in obstructive group.
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