Impact of the new European respiratory (ERS)/American Thoracic Society (ATS) pulmonary function test interpretation guidelines 2021 on the interpretation of bronchodilator responsiveness in subjects with airway obstruction.

The impact of the new 2021 European Respiratory Society (ERS)/American Thoracic Society (ATS) pulmonary function test interpretation guidelines on the interpretation of bronchodilator responsiveness (BDR) in subjects with airway obstruction is still required. Therefore, the objective of this study was to explore the agreement between the 2005 and 2021 ERS/ATS criteria regarding the interpretation of the BDR. Moreover, we explore the factors that influenced the discordance of positive bronchodilator responsiveness (BDR+) between these two criteria. The agreement regarding the interpretation of BDR + between the two criteria was assessed using kappa (κ). The percentage of agreement in the interpretation of BDR + between the two criteria was calculated. The factors that influenced the discordance of BDR + between these two criteria were also analyzed. A total of 500 subjects with a mean age of 60.5 ± 15.6 years, 62.2% male were included. The study observed a good level of agreement in the interpretation of BDR + between the two criteria with kappa values = 0.782. The percentages of agreement on the interpretation of BDR + between the two criteria were high, with values = 90.6%. Male sex was the only factor that influenced the discordance of BDR + between these two criteria. A good level of agreement was observed in the interpretation of BDR + between the 2005 and 2021 criteria. Therefore, the 2005 and 2021 ERS/ATS criteria for BDR can be used interchangeably. However, the discordance of BDR + between these two criteria could be affected by sex.

Chaiwong W ，Deesomchok A ，Pothirat C ，Duangjit P ，Liwsrisakun C ... -  《-》

A New Bronchodilator Response Grading Strategy Identifies Distinct Patient Populations.

Hansen JE ，Dilektasli AG ，Porszasz J ，Stringer WW ，Pak Y ，Rossiter HB ，Casaburi R ... -  《-》

Bronchodilator Responsiveness Defined by the 2005 and 2021 ERS/ATS Criteria in Patients with Asthma as Well as Chronic Obstructive Pulmonary Disease.

In the 2021 ERS/ATS interpretive strategies for routine lung function tests, a positive bronchodilator response (BDR) was updated as a change of >10% relative to the predicted value in forced expiratory volume in 1 second (FEV1) or forced vital capacity (FVC). We aimed to explore the differences between the 2005 and 2021 ERS/ATS criteria applied to patients with asthma as well as chronic obstructive pulmonary disease (COPD). BDR test data about asthma patients aged 6-80 years and COPD patients aged 18-80 years were derived from the National Respiratory Medicine Center, First Affiliated Hospital of Guangzhou Medical University, from January 2017 to March 2022. BDR results defined by the 2005 and 2021 ERS/ATS criteria were named 2005-BDR and 2021-BDR, respectively. We compared differences between 2005-BDR and 2021-BDR and analyzed the trend in the proportion of positive BDR (BDR+) with the level of airflow obstruction. A total of 4457 patients with asthma and 7764 patients with COPD were included in the analysis. The percentages of 2005-BDR+ and 2021-BDR+ were 63.32% and 52.84% for asthma, 30.92% and 22.94% for COPD, respectively. Of patients with 2005-BDR+, 81.86% for asthma and 70.18% for COPD showed 2021-BDR+ results, and these patients had higher FEV1%pred, FVC%pred (all P<0.05). Whichever BDR criterion was adopted, the proportion of BDR+ had an upward linear trend with the increased degree of airflow obstruction in COPD, but exhibited an approximate inverted U-shaped curve in asthma. In COPD, the proportion of BDRFEV1 was negatively associated with the degree of airflow obstruction, while BDRFVC was positively associated (all P<0.05). Compared with 2005-BDR+, the proportion of 2021-BDR+ reduced markedly in patients with asthma and COPD, but their trends with the degree of airflow obstruction did not change. Patients with consistent BDR+ had higher initial FEV1%pred and FVC%pred.

Li Y ，Lin J ，Wang Z ，Wang Z ，Tan L ，Liu S ，Huang J ，Gao Y ，Zheng J ... -  《International Journal of Chronic Obstructive Pulmonary Disease》

Combined Forced Expiratory Volume in 1 Second and Forced Vital Capacity Bronchodilator Response, Exacerbations, and Mortality in Chronic Obstructive Pulmonary Disease.

Fortis S ，Comellas A ，Make BJ ，Hersh CP ，Bodduluri S ，Georgopoulos D ，Kim V ，Criner GJ ，Dransfield MT ，Bhatt SP ，COPDGene Investigators–Core Units: <italic>Administrative Center</italic>, COPDGene Investigators–Clinical Centers: <italic>Ann Arbor VA</italic> ... -  《-》

Which bronchodilator reversibility criteria can predict severe acute exacerbation in chronic obstructive pulmonary disease patients?

Kim J ，Kim WJ ，Lee CH ，Lee SH ，Lee MG ，Shin KC ，Yoo KH ，Lee JH ，Lim SY ，Na JO ，Hwang HG ，Hong Y ，Lim MN ，Yoo CG ，Jung KS ，Lee SD ... -  《-》