Canadian Prediction Equations of Spirometric Lung Function for Caucasian Adults 20 to 90 Years of Age: Results from the Canadian Obstructive Lung Disease (COLD) Study and the Lung Health Canadian Environment (LHCE) Study

Tan, W.C.; Bourbeau, Jean; Hernández, Paul; Chapman, Kylie; Cowie, Robert L.; FitzGerald, MJ; Aaron, Shawn D.; Marciniuk, DD; Maltais, François; De, OʼDonnell; Goldstein, Roger; Sin, Don D.; Chan‐Yeung, Moira; Manfreda, Jure; Anthonisen, N. R.; Rb, Tate; Sears,; Hc, Siersted; Becklake,; Ernst, Pierre; Bowie, DM; Sweet, Lamont; Til, Linda Van

doi:10.1155/2011/540396

Cited by 57 publications

(43 citation statements)

References 27 publications

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“…To determine the relationship between the SR and EFL, eighty-four young healthy subjects were analyzed from published data (Dominelli et al, 2013, 2011, 2015b, 2014b). All subjects were non-smokers and had normal spirometry (Tan et al, 2011). Resting spirometric data was assessed by a qualified respirologist who was blinded to whether or not subjects developed EFL during exercise.…”

Section: Methodsmentioning

confidence: 99%

Quantifying the shape of maximal expiratory flow-volume curves in healthy humans and asthmatic patients

Dominelli

Molgat‐Seon

Foster

et al. 2016

Respiratory Physiology & Neurobiology

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Differences in the absolute flow and volume of maximal expiratory flow-volume (MEFV) curves have been studied extensively in health and disease. However, the shapes of MEFV curves have received less attention. We questioned if the MEFV curve shape was associated with (i) expiratory flow limitation (EFL) in health and (ii) changes in bronchial caliber in asthmatics. Using the slope-ratio (SR) index, we quantified MEFV curve shape in 84 healthy subjects and 8 matched asthmatics. Healthy subjects performed a maximal exercise test to assess EFL. Those with EFL during had a greater SR (1.15 ± 0.20 vs. 0.85 ± 0.20, p < 0.05) yet, there was no association between maximal oxygen consumption and SR (r = 0.14, p > 0.05). Asthmatics average SR was greater than the healthy subjects (1.35 ± 0.03 vs. 0.90 ± 0.11, p < 0.05), but there were no differences when bronchial caliber was manipulated. In conclusion, a greater SR is related to EFL and this metric could aid in discriminating between groups known to differ in the absolute size of MEFV curves.

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Section: Methodsmentioning

confidence: 99%

Quantifying the shape of maximal expiratory flow-volume curves in healthy humans and asthmatic patients

Dominelli

Molgat‐Seon

Foster

et al. 2016

Respiratory Physiology & Neurobiology

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“…All procedures adhered to the Declaration of Helsinki and were approved by the Clinical Research Ethics Board at the University of British Columbia. Subjects had a wide range of exercise participation (recreational to national calibre athletics), did not report any current or previous cardiorespiratory ailments and had spirometry parameters within normal limits (Tan et al 2011; Table 1). Although not universally established, studies in which conjugates of oestrogen and progesterone have been measured have demonstrated significant inter-and intrasubject variability with respect to hormone levels throughout the menstrual cycle, but with no effect on submaximal exercise ventilation (Beidleman et al 1999;MacNutt et al 2012).…”

Section: Subjectsmentioning

confidence: 99%

“…When compared with height‐matched men, women have smaller lungs (Tan et al . ) and conducting airways (Mead, ; Sheel et al . ).…”

Section: Introductionmentioning

confidence: 99%

“…There are well-documented sex differences with respect to airway anatomy and the respiratory mechanics associated with exercise hyperpnoea. When compared with height-matched men, women have smaller lungs (Tan et al 2011) and conducting airways (Mead, 1980;Sheel et al 2009). During dynamic whole-body exercise, women develop expiratory flow limitation (EFL) more often (McClaran et al 1998;Guenette et al 2007) and have a greater mechanical WOB for a givenV E above ß 65 l min −1 (Wanke et al 1991;Guenette et al 2009).…”

Section: Introductionmentioning

confidence: 99%

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Oxygen cost of exercise hyperpnoea is greater in women compared with men

Dominelli

Render

Molgat‐Seon

et al. 2015

The Journal of Physiology

116

130

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Key pointsr The oxygen cost of breathing represents a significant fraction of total oxygen uptake during intense exercise.r At a given ventilation, women have a greater work of breathing compared with men, and because work is linearly related to oxygen uptake we hypothesized that their oxygen cost of breathing would also be greater.r For a given ventilation, women had a greater absolute oxygen cost of breathing, and this represented a greater fraction of total oxygen uptake.r Regardless of sex, those who developed expiratory flow limitation had a greater oxygen cost of breathing at maximal exercise.r The greater oxygen cost of breathing in women indicates that a greater fraction of total oxygen uptake (and possibly cardiac output) is directed to the respiratory muscles, which may influence blood flow distribution during exercise.Abstract We compared the oxygen cost of breathing (V O 2 RM ) in healthy men and women over a wide range of exercise ventilations (V E ). Eighteen subjects (nine women) completed 4 days of testing. First, a step-wise maximal cycle exercise test was completed for the assessment of spontaneous breathing patterns. Next, subjects were familiarized with the voluntary hyperpnoea protocol used to estimateV O 2 RM . During the final two visits, subjects mimicked multiple times (four to six) the breathing patterns associated with five or six different exercise stages. Each trial lasted 5 min, and on-line pressure-volume and flow-volume loops were superimposed on target loops obtained during exercise to replicate the work of breathing accurately. At ß55 l min −1 V E ,V O 2 RM was significantly greater in women. At maximal ventilation, the absoluteV O 2 RM was not different (P > 0.05) between the sexes, but represented a significantly greater fraction of whole-bodyV O 2 in women (13.8 ± 1.5 vs. 9.4 ± 1.1%V O 2 ). During heavy exercise at 92 and 100% V O 2 max , the unit cost ofV E was +0.7 and +1.1 ml O 2 l −1 greater in women (P < 0.05). AtV O 2 max , men and women who developed expiratory flow limitation had a significantly greaterV O 2 RM than those who did not (435 ± 44 vs. 331 ± 30 ml O 2 min −1 ). In conclusion, women have a greateṙ V O 2 RM for a givenV E , and this represents a greater fraction of whole-bodyV O 2 . The greaterV O 2 RM in women may have implications for the integrated physiological response to exercise. Abbreviations EFL, expiratory flow limitation; MEFV, maximal expiratory flow-volume;V E , expired minute ventilation;V Emax , maximal expired minute ventilation;V O2 , oxygen uptake;V O2 max , maximal oxygen uptake;V O2RM , oxygen uptake of the respiratory muscles; WOB, work of breathing.

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“…We used data from the Canadian Cohort of Obstructive Lung Disease (COLD) to assign a binary COPD status to individuals upon their creation. COLD was a nationally representative, population-based cross-sectional study of 3,042 Canadians 40 years of age or older(25). Using these data, we developed sex-specific logistic regression equations for the probability of having COPD as a function of sex, age, and smoking pack-years ( Table 1 and Appendix 3 ).…”

Section: Methodsmentioning

confidence: 99%

Development and validation of the Evaluation Platform In COPD (EPIC): a population-based outcomes model of COPD for Canada

Sadatsafavi

Ghanbarian

Adibi

et al. 2018

Preprint

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BackgroundWe report the development, validation, and implementation of an open-source population-based outcomes model of Chronic Obstructive Pulmonary Disease (COPD) for Canada.MethodsEvaluation Platform in COPD (EPIC) is a discrete event simulation model of Canadians 40 years of age or older. Three core features of EPIC are its open-population design (incorporating projections of future population growth, aging, and smoking trends), its incorporation of heterogeneity in lung function decline and burden of exacerbations, and its modeling of the natural history of COPD from inception. Multiple original data analyses, as well as values reported in the literature, were used to populate the model. Extensive face validity as well as internal and external validity evaluations were performed.ResultsThe model was internally validated on demographic projections, mortality rates, lung function trajectories, COPD exacerbations, and stability of COPD prevalence over time within strata of risk factors. In external validation, it moderately overestimated rate of overall exacerbations in two independent trials, but generated consistent estimates of rate of severe exacerbations and mortality.LimitationsIn its current version, EPIC does not consider uncertainty in the evidence. Several components such as additional (e.g., environmental and occupational) risk factors, treatment, symptoms, and comorbidity will have to be added in future iterations.ConclusionsEPIC is the first multi-purpose outcome- and policy-focused model of COPD for Canada. By modeling the natural history of COPD from its inception, it is capable of modeling the outcomes of decisions across the entire care pathway of COPD. Platforms of this type have the capacity to be iteratively updated to incorporate the latest evidence and to project the outcomes of many different scenarios within a consistent framework.

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Canadian Prediction Equations of Spirometric Lung Function for Caucasian Adults 20 to 90 Years of Age: Results from the Canadian Obstructive Lung Disease (COLD) Study and the Lung Health Canadian Environment (LHCE) Study

Abstract: These spirometry reference equations, derived from randomly selected population-based cohorts with stringently monitored lung function measurements, provide data currently lacking in Canada.

Cited by 57 publications

References 27 publications

Quantifying the shape of maximal expiratory flow-volume curves in healthy humans and asthmatic patients

Quantifying the shape of maximal expiratory flow-volume curves in healthy humans and asthmatic patients

Oxygen cost of exercise hyperpnoea is greater in women compared with men

Development and validation of the Evaluation Platform In COPD (EPIC): a population-based outcomes model of COPD for Canada

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