From the Guidelines
An FEV1/FVC ratio of 84% with an FVC of 88% indicates normal lung function without evidence of obstructive or restrictive lung disease, and according to the most recent guidelines from the GOLD science committee 1, no specific respiratory treatment is needed for these values, as they fall within normal parameters. The FEV1/FVC ratio is considered normal when it's above 70-75% in adults, and your value of 84% is well above this threshold. Similarly, an FVC of 88% is within normal range (typically considered normal when above 80% of predicted value) 1. These values suggest you can breathe out a normal proportion of air in the first second of forced expiration (FEV1) compared to your total lung capacity (FVC).
Key Points to Consider:
- The GOLD 2025 report recommends that 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.
- Management should focus on maintaining good respiratory health through regular exercise, avoiding smoking, minimizing exposure to air pollutants, and addressing any respiratory symptoms if they develop despite these normal values.
- If you're experiencing respiratory symptoms despite these normal pulmonary function tests, further evaluation may be warranted to identify other potential causes.
Important Considerations for Management:
- Regular follow-up and monitoring may be necessary to ensure that lung function remains within normal parameters, especially if there are risk factors for developing chronic obstructive pulmonary disease (COPD) or other respiratory conditions 1.
- The use of post-bronchodilator spirometry is recommended for the diagnosis of COPD, and the FEV1/FVC ratio is a key component of this diagnosis 1.
From the Research
Interpretation of FEV1/FVC Ratio and FVC
- An FEV1/FVC ratio of 84 with an FVC of 88 indicates that the patient's forced expiratory volume in one second (FEV1) is 84% of their forced vital capacity (FVC), and their FVC is 88% of the predicted normal value 2, 3.
- According to the Global Initiative for Obstructive Lung Disease (GOLD), a low FEV1/FVC ratio is used to confirm the presence of airflow obstruction in the diagnosis of chronic obstructive pulmonary disease (COPD) 2.
- The FEV1/FVC ratio is a more robust measure of airflow obstruction than FEV1 percent predicted (ppFEV1), and it can be used to classify the severity of COPD 3.
Severity Classification
- The STaging of Airflow obstruction by Ratio (STAR) classification system uses the FEV1/FVC ratio to classify the severity of airflow obstruction, with a ratio of <0.70 indicating airflow obstruction 3.
- The STAR classification system has been shown to provide similar predictions of breathlessness and mortality as the GOLD classification system, but with a more uniform gradation of disease severity 3.
- The FEV1/FVC ratio can be used to identify patients with early or mild obstructive lung disease, even in those with normal spirometry results 4.
Management
- Patients with an FEV1/FVC ratio of 84 and an FVC of 88 should be managed according to the severity of their airflow obstruction, as classified by the STAR or GOLD systems 2, 3.
- Management may include lifestyle modifications, such as smoking cessation and exercise, as well as pharmacological treatments, such as bronchodilators and corticosteroids 2, 3.
- It is also important to consider other spirometric measures, such as FEF75 and FEF25-75, in the clinical evaluation of airway obstruction, as they may be more sensitive than FEV1 in detecting obstruction 5.