Journal of Diagnostics Concepts & Practice >

2023 , Vol. 22 >Issue 03: 234 - 237

DOI: https://doi.org/10.16150/j.1671-2870.2023.03.05

Interpretation of guidelines

Phenotypes of chronic obstructive pulmonary disease with preserved ratio impaired spirometry (PRISm)

Expand
  • Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine,Institute of Respiratory Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Emergency Prevention, Control, and Diagnosis of Respiratory Infectious Diseases, Shanghai 200025

Received date: 2023-05-08

  Online published: 2023-11-17

Fold

Abstract

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 first proposed “Preserved Ratio Impaired Spirometry (PRISm)”, which is the ratio of post-bronchodilator forced expiratory volume in one second to forced vital capacity is normal (FEV1/FVC ≥ 0.7) as pulmonary ventilation function is impaired (post-bronchodilator FEV1% and/ or FVC%<80%. It is particularly necessary to pay attention to the PRISm population with significant FVC deterioration. PRISm was associated with increased incidence of complications and all-cause mortality in the patients with in chronic obstructive pulmonary disease (COPD). In GOLD 2023, it was clarified that PRISm patients should be considered as COPD patients for early screening, standardized treatment, due to their significant clinical symptoms, lung function deterioration, and or abnormal bronchoalveolar structure even if their airway limitation does not meet the criteria for COPD. The cohort studies for large sample, multi-center, long-term follow-up with PRISm in China should be investigated in future.

Key words： Preserved ratio impaired; Chronic obstructive pulmonary disease; Disease management; Global initiative

Cite this article

SUN Xianwen, LI Qingyun . Phenotypes of chronic obstructive pulmonary disease with preserved ratio impaired spirometry (PRISm)[J]. Journal of Diagnostics Concepts & Practice, 2023 , 22(03) : 234 -237 . DOI: 10.16150/j.1671-2870.2023.03.05

References

[1] Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease[R/OL]. https://goldcopd.org/2023-gold-report-2/.
[2] WAN E S, HOKANSON J E, MURPHY J R, et al. Clinical and radiographic predictors of GOLD-unclassified smokers in the COPDGene study[J]. Am J Respir Crit Care Med, 2011, 184(1):57-63.
[3] HAN M K, AGUSTI A, CELLI B R, et al. From GOLD 0 to Pre-COPD[J]. Am J Respir Crit Care Med, 2021, 203(4):414-423.
[4] MARTINEZ F J, AGUSTI A, CELLI B R, et al. Treatment Trials in young patients with chronic obstructive pulmonary disease and pre-chronic obstructive pulmonary disease patients: time to move forward[J]. Am J Respir Crit Care Med, 2022, 205(3):275-287.
[5] WAN E S, HOKANSON J E, REGAN E A, et al. Significant spirometric transitions and preserved ratio impaired spirometry among ever smokers[J]. Chest, 2022, 161(3):651-661.
[6] WAN E S, FORTIS S, REGAN E A, et al. Longitudinal phenotypes and mortality in preserved ratio impaired spirometry in the COPD gene study[J]. Am J Respir Crit Care Med, 2018, 198(11):1397-1405.
[7] LITTLETON S W, TULAIMAT A. The effects of obesity on lung volumes and oxygenation[J]. Respir Med, 2017, 124:15-20.
[8] LEONE N, COURBON D, THOMAS F, et al. Lung function impairment and metabolic syndrome: the critical role of abdominal obesity[J]. Am J Respir Crit Care Med, 2009, 179(6):509-516.
[9] WIJNANT S R A, DE ROOS E, KAVOUSI M, et al. Trajectory and mortality of preserved ratio impaired spirome-try: the Rotterdam Study[J]. Eur Respir J, 2020, 55(1):1901217.
[10] HIGBEE D H, GRANELL R, DAVEY SMITH G, et al. Prevalence, risk factors, and clinical implications of preserved ratio impaired spirometry: a UK Biobank cohort analysis[J]. Lancet Respir Med, 2022, 10(2):149-157.
[11] SCHWARTZ A, ARNOLD N, SKINNER B, et al. Preserved Ratio Impaired Spirometry in a Spirometry Database[J]. Respir Care, 2021, 66(1):58-65.
[12] PARK H J, BYUN M K, RHEE C K, et al. Significant predictors of medically diagnosed chronic obstructive pulmonary disease in patients with preserved ratio impaired spirometry: a 3-year cohort study[J]. Respir Res, 2018, 19(1):185.
[13] WEI X, DING Q, YU N, et al. Imaging features of chronic bronchitis with preserved ratio and impaired spirometry (PRISm)[J]. Lung, 2018, 196(6):649-658.
[14] WAN E S, BALTE P, SCHWARTZ J E, et al. Association Between Preserved Ratio Impaired Spirometry and Clinical Outcomes in US Adults[J]. JAMA, 2021, 326(22):2287-2298.
[15] KIM J, LEE C H, LEE H Y, et al. Association between comorbidities and preserved ratio impaired spirometry: using the Korean National Health and Nutrition Examination Survey Ⅳ-Ⅵ[J]. Respiration, 2022, 101(1):25-33.
[16] WASHIO Y, SAKATA S, FUKUYAMA S, et al. Risks of mortality and airflow limitation in Japanese individuals with preserved ratio impaired spirometry[J]. Am J Respir Crit Care Med, 2022, 206(5):563-572.
[17] BUI D S, LODGE C J, BURGESS J A, et al. Childhood predictors of lung function trajectories and future COPD risk: a prospective cohort study from the first to the sixth decade of life[J]. Lancet Respir Med, 2018, 6(7):535-544.
[18] HAN M K, YE W, WANG D, et al. Bronchodilators in tobacco-exposed persons with symptoms and preserved lung function[J]. N Engl J Med, 2022, 387(13):1173-1184.
Options
Outlines

/

〈 〉