The Characteristics of the Concavity of Descending Limb of Maximal Expiratory Flow-Volume Curves Generated by Spirometry.

IF 4.6 2区医学 Q1 RESPIRATORY SYSTEM

Lung Pub Date : 2025-01-03 DOI:10.1007/s00408-024-00775-2

Zhufeng Wang, Lina Liang, Feifei Huang, Kang Peng, Junfeng Lin, Yi Gao, Jinping Zheng

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引用次数: 0

Abstract

Purpose: This study examined the concavity (angle β, central and peripheral concavity) of the descending limb of the maximal expiratory flow-volume (MEFV) curves to reflect various ventilatory defects, including obstructive, restrictive, or mixed patterns.

Methods: We conducted a cross-sectional study collecting spirometry data from a healthcare center and a tertiary hospital between 2017 and 2022, with additional raw flow-volume curve data from primary healthcare institutions in 2023. We analyzed differences in concavity between spirometric patterns. Receiver operating characteristic curves were used to assess the predictive power of concavity for spirometric patterns. The relationship among concavity indices was examined.

Results: This study included 18,938 cases, with 22% exhibiting an obstructive pattern. The dataset comprised 14,868 cases for training, 3716 cases for validation, and 354 cases for testing. In the training set, the mean angle β were 180.3 ± 12.4 and 148.5 ± 12.7 degrees in normal and obstruction patterns. The angle β had an AUC of 0.970 (95% CI 0.966-0.973) for identifying normal and obstructive patterns, with a cut-off value of 163.0 degrees. In the validation set, out of 2311 cases with a normal forced vital capacity (FVC), 3.1% cases exhibited a Z-score of forced expiratory volume in 1 s to FVC ratio (FEV₁/FVC) ≥ - 1.645 but an angle β < 163.0 degrees. In testing set, a correlation coefficient of - 0.96 and - 0.79 was found between the angle β and the central or peripheral concavity.

Conclusion: The concavity of the descending limb of MEFV curves may be crucial in identifying spirometric patterns.

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肺活量测定法生成的最大呼气流量-容积曲线降肢凹度特征。

目的：本研究检测最大呼气流量-容积（MEFV）曲线降肢的凹度（角β，中央和外周凹度），以反映各种通气缺陷，包括阻塞性，限制性或混合型。方法：我们进行了一项横断面研究，收集了2017年至2022年来自一家医疗保健中心和一家三级医院的肺活量测定数据，以及2023年来自初级医疗保健机构的原始流量-容量曲线数据。我们分析了不同肺活量测定模式的凹度差异。使用受试者工作特征曲线来评估肺量测定模式的凹度预测能力。考察了凹凸度指标之间的关系。结果：本研究纳入18938例，其中22%表现为阻塞性。该数据集包括14,868个用于训练的案例，3716个用于验证的案例和354个用于测试的案例。在训练集中，正常模式和阻塞模式的平均角度β分别为180.3±12.4度和148.5±12.7度。角β识别正常和阻塞模式的AUC为0.970 (95% CI 0.966-0.973)，临界值为163.0度。在验证集中，2311例用力肺活量（FVC）正常的患者中，3.1%的患者用力呼气量1 s /FVC比值（FEV1/FVC） z评分≥- 1.645，但角度为β。结论：MEFV曲线下降肢的凹凸度可能是识别肺活量模式的关键。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lung 医学-呼吸系统

CiteScore

9.10

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.