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Preserved ratio impaired spirometry with or without restrictive spirometric abnormality.

Shinichiro Miura1, Hiroshi Iwamoto2, Keitaro Omori3

  • 1Department of Molecular and Internal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.

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|February 22, 2023
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Preserved ratio impaired spirometry (PRISm) can be restrictive or non-restrictive. Non-restrictive PRISm, unlike restrictive PRISm, may predict future airflow obstruction and warrants closer monitoring.

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Area of Science:

  • Pulmonary Medicine
  • Respiratory Physiology

Background:

  • Preserved ratio impaired spirometry (PRISm) is characterized by reduced FEV1 with a normal FEV1/FVC ratio.
  • Some individuals with PRISm exhibit restrictive ventilatory abnormalities, while others do not.

Purpose of the Study:

  • To differentiate the clinical features of restrictive and non-restrictive PRISm.
  • To investigate the longitudinal risk of developing airflow obstruction in different PRISm subgroups.

Main Methods:

  • Analysis of spirometry data from 11,246 participants across five healthcare centers.
  • Categorization into restrictive PRISm, non-restrictive PRISm, and airflow obstruction groups.
  • Longitudinal assessment of 2,141 participants over 5 years to evaluate the risk of developing airflow obstruction.

Main Results:

  • Asthma or smoking history are risk factors for non-restrictive PRISm, which is linked to developing airflow obstruction.
  • Female sex, older age, and higher BMI are risk factors for restrictive PRISm.
  • Restrictive PRISm is not associated with the development of airflow obstruction.

Conclusions:

  • PRISm can be classified based on the presence or absence of restrictive abnormalities.
  • Non-restrictive PRISm may represent a precursor to chronic obstructive pulmonary disease (COPD).
  • Increased monitoring is recommended for individuals with non-restrictive PRISm.