FEV1 /FVC <70% — Is it the COPD absolute marker?

S.I. Ovcharenko¹, Z.R. Aisanov², G.L. Ignatova³, I.V. Leshchenko⁴, V.Yu. Mishlanov<sup>5

1</sup>Sechenov University, Moscow
²Pirogov Russian National Research Medical University, Moscow
³South Ural State Medical University, Chelyabinsk
⁴Ural State Medical University, Yekaterinburg
⁵Perm State Medical University named after E.A.КWagner

The article presents a discussion that unfolded around the post-bronchodilator indicator FEV₁/FVC <0.7 as an indispensable criterion for the diagnosis of chronic obstructive pulmonary disease (COPD) in patients older than 40 and exposed to airborne pollutants. The indicator conditionality is presented: the lower age norm for people under 50Р55 is higher than 0.7 and in older age groups (over 65) С lower than 0.7, which can cause both overdiagnosis and underdiagnosis of the disease. At the same time, an issue arose about the spirometric maneuver quality and determining fixed bronchial obstruction. This is crucial for diagnosing COPD.
The prospective non-interventional study results based on the compilation and assessment of a patient register with chronic bronchial obstructive diseases in the Perm region are presented. A group of patients with typical COPD manifestations, but without reliable functional characteristic (FEV₁/FVC <0.7), was isolated. A discussion is presented on the isolating possibility of separate disease form, the distinctive features of which is the reduction in FEV₁, without reducing FEV₁/FVC.
The clinical features of this patient category are given. As a rule, they are distinguished by the following parameters: high frequency of cardiovascular diseases; emphysema minimal manifestations; diffuse peribronchial fibrosis pronounced manifestations (mainly in the upper and middle parts of the lungs); distinctness by bronchial and systemic inflammation signs. It is recommended to treat such patients in the same way as patients with COPD using the same drugs.
The article shows the need for long-term dynamic monitoring of this patient category and the continuation of scientific research to answer the question: what is the disease natural development in such patients and will they progress towards COPD. To date, there is no more accessible and significant marker for the COPD diagnosis in real clinical practice as the post-bronchodilator ratio of FEV₁/FVC <0.7. Perhaps in the future, new, more sensitive and reliable criteria for COPD diagnosis will appear, especially at the early stages of its development.

Keywords: pulmonology, chronic obstructive pulmonary disease, COPD, chronic bronchial obstructive pulmonary disease, FEV₁, FVC, risk factors, patient register.
For citation: Ovcharenko S.I., Aisanov Z.R., Ignatova G.L. et al. FEV1/FVC <70% С Is it the COPD absolute marker? RMJ. Medical Review. 2019;9(I):9-12.