Bronchodilator reversibility in chronic obstructive pulmonary disease: use and limitations.
The change in forced expiratory volume in 1 s (FEV1) after administration of a short-acting bronchodilator has been widely used to identify patients with chronic obstructive pulmonary disease (COPD) who have a potentially different disease course and response to treatment. Despite the apparent simplicity of the test, it is difficult to interpret or rely on. Test performance is affected by the day of testing, the severity of baseline lung-function impairment, and the number of drugs given to test. Recent data suggest that the response to bronchodilators is not enhanced in patients with COPD and does not predict clinical outcomes. In this Review we will discuss the insight that studies of bronchodilator reversibility have provided into the nature of the COPD, and how the abnormal physiology seen in patients with this disorder can be interpreted.
School of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK; Aintree Chest Centre, University Hospital Aintree, Liverpool, UK. Electronic address: pmacal@liverpool.ac.uk.
Peter M A
PM
Calverley
Aintree Chest Centre, University Hospital Aintree, Liverpool, UK.
Paul
P
Albert
Aintree Chest Centre, University Hospital Aintree, Liverpool, UK.
Paul P
PP
Walker
D016535:Bronchial Hyperreactivity / Q000188:drug therapy / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D005541:Forced Expiratory Volume / Q000187:drug effects; D005544:Forecasting; D006801:Humans; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity / Q000187:drug effects
D001993:Bronchodilator Agents