From the Guidelines
The spirometry results showing an FEV1/FVC ratio of 82% and post-bronchodilator FEV1 of 77% indicate normal lung function without evidence of obstructive airway disease, as the FEV1/FVC ratio is above the threshold value of 0.7 recommended by the GOLD Science Committee 1.
Interpretation of Spirometry Results
The FEV1/FVC ratio of 82% is above the lower limit of normal, ruling out obstructive disorders like asthma or COPD.
- The post-bronchodilator FEV1 of 77% is also within normal range, typically above 80% is considered normal, but 77% may be normal depending on the individual's predicted values.
- The lack of significant improvement after Ventolin administration further suggests absence of reversible airway obstruction.
Management
These results should be interpreted in the context of the patient's symptoms, medical history, and other clinical findings.
- If the patient is experiencing respiratory symptoms despite these normal spirometry results, further evaluation may be warranted, including additional pulmonary function tests, imaging studies, or consideration of non-pulmonary causes for their symptoms.
- According to the GOLD Science Committee recommendations, the presence or absence of airflow obstruction should be confirmed by repeat spirometry on a separate occasion if the post-BD FEV/FVC ratio is between 0.60 and 0.80 1.
Clinical Considerations
The approach to integrated and comprehensive management in COPD should include diagnosis confirmed with postbronchodilator spirometry, clinical evaluation, and routine follow-up and assessment, as well as comprehensive management comprising evidence-informed nonpharmacological and pharmacological interventions and patient supportive health care system practices 1.
- The use of post-BD spirometry results in fewer diagnosed COPD cases, while also ensuring that discordant individuals characterized by greater volume responses with more severe disease characteristics are not overlooked 1.
From the Research
Interpretation of Spirometry Results
- The FEV1/FVC ratio of 82% is below the normal range, indicating an obstructive pattern 2.
- The FEV1 of 77% is also below the normal range, suggesting impaired lung function 2.
- Post-bronchodilator spirometry values are used to define and severity classify chronic obstructive pulmonary disease (COPD) 2.
Management of COPD
- Long-acting bronchodilators, including beta-2 agonists and muscarinic antagonists, are the mainstay of maintenance treatment for COPD 3.
- Combination therapy with inhaled corticosteroids (ICS), long-acting beta-2 agonists (LABAs), and long-acting muscarinic antagonists (LAMAs) may be beneficial for patients with frequent exacerbations and elevated blood eosinophil counts 4.
- The choice of bronchodilator therapy should be individualized based on patient factors, such as symptom severity, exacerbation history, and comorbidities 5, 3.