Hello. 44 year old just diagnosed
with COPD. 7-10 pack years quit 13 years ago. Childhood asthma.
My values:
2023:
FEV1: 3.37 (91%)
FVC: 5.17 (112%)
FEV1/FVC: 65
TLC, VC, Diffusion is normal. DLCO is normal.
There was no post-bronchodilator testing done. No challenge test either.
2015:
Pre:
FEV1: 3.75 (94%)
FVC: 5.13 (107%)
FEV1/FVC: 73
Post:
FVC: 5.19
FEV1: 3.77
FEV1/FVC: 73
27% decrease in FEV1 with methacholine challenge in 2015.
The study below is about young COP patients. Can anyone help me clarify what is meant by the following statements in this study:
https://erj.ersjournals.com/content/44/2/324
"The severity distribution and progression of disease in younger patients with COPD is similar to that of patients of older age. This observation suggests that younger individuals presenting with COPD develop the disease from an already compromised pulmonary and systemic status, complementing the model of steeper decline of lung function proposed by Fletcher and Peto."
"As can be seen in table 2, and figure 2a and b, the rate of FEV1 decline was almost equal and parallel for both groups at all baseline GOLD grades (fig. 2c). This suggests that the severity of COPD is already established at a young age and that patients maintain their trajectory over time so that the relative position at younger age determines their final position at an older age. "
Also, based on figure 2c above, for the 50 year old with FEV1 above 90, which so far looks like me a bit, does this mean that I may hope for the same trajectory of the magenta line as a 44year old with an FV1 of 91%? Does this mean that because I have such a high FEV1 I may have more relative time left? I understand this comes down to many variables, such as how I take care of myself, and acts of God, and I certainly don't expect anyone to be able to tell me with certainly how my life will turn out. I'm just trying to get more perspective on this.
When I first read this, I was discouraged, since it in many ways clashed with the Fletcher Peto model that is very optimistic, but I guess considering my FEV1 values, it's not that bad.
Thank you in advance.
Fletcher and Peto model of decline that the study above challenges:
(https://erj.ersjournals.com/content/44/2/280.long)
graph: (https://qph.cf2.quoracdn.net/main-qimg-cda82631346...)
Another optimistic study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC48396...