Preserved Ratio Impaired Spirometry (PRISm) from an Epidemiological Perspective

Area of Science:

• Pulmonary Medicine
• Epidemiology
• Cardiology

Background:

• Preserved ratio impaired spirometry (PRISm) is characterized by post-bronchodilator FEV1/FVC ratio above the lower limit of normal but with FEV1 below 80% predicted.
• Its prevalence ranges from 3% to 20% and is associated with functional limitations, symptoms, comorbidities, and mortality.
• PRISm does not denote a specific lung disease but serves as an indicator of respiratory impairment.

Purpose of the Study:

• To analyze PRISm prevalence in a well-characterized epidemiological cohort.
• To investigate the influence of comorbidities on PRISm development.
• To assess the impact of PRISm on overall mortality.

Main Methods:

• Analysis of 3403 healthy subjects and 507 individuals with PRISm from the Study of Health in Pomerania (SHIP).
• Comparison of lung function, cardiopulmonary exercise testing (CPET), and echocardiography data between PRISm and non-PRISm groups.
• Evaluation of comorbidities, cardiovascular mortality, and all-cause mortality.

Main Results:

• The PRISm group exhibited higher rates of myocardial infarction, hypertension, type 2 diabetes, dyspnea, and lung disease.
• Individuals with PRISm were older, more likely current smokers, and had higher body fat markers.
• The PRISm group showed more unfavorable lung function, CPET, and echocardiographic parameters, with increased all-cause and cardiovascular mortality.

Conclusions:

• PRISm is associated with cardiovascular comorbidities, increased dyspnea, and impaired exercise capacity.
• The findings highlight PRISm as a significant risk factor for mortality.
• Further research is needed to elucidate the underlying mechanisms and longitudinal progression of PRISm.