Chest
Volume 138, Issue 5, November 2010, Pages 1037-1040
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Editorials
Point/Counterpoint Editorials
Point: Should We Abandon FEV1/FVC <0.70 To Detect Airway Obstruction? No

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      The signal activated by ACh induces an altered structure and function, which manifests itself in an increase in the density of the parasympathetic ganglia (neuronal plasticity), resulting in an additional release of ACh and the creation of a vicious circle [28]. The classical operational definition of AL (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.70 [29]) may underestimate its presence in children and young adults and overestimate it in males aged >40 years and females >50 years [30,31]. A slightly decreased FEV1/FVC ratio in an elderly non-smoker has not the same value as in a younger smoker.

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      It can also be used to assess the response to therapy that is improving the air passage through bronchi, such as bronchodilators and monitoring disease progression. The FEV1% is the ratio of FEV1 to FVC (expressed as a fraction or percentage) that is the most useful spirometry parameter which is a marker of airway obstruction (Celli and Halbert, 2010; Cerveri et al., 2008; Juusela et al., 2013; Khan et al., 2010). Values of FEV1 and FVC are measured in liters and are also expressed as a percentage of the predicted values for that individual.

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    Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Celli has been reimbursed by GlaxoSmithKline, Boehringer Ingelheim, Pfizer, AstraZeneca, Almirall, Aerys, and Esteve for participating in advisory boards and has spoken at different meetings. The division he works in has been awarded research grants for different medication trials by the same companies and for the discovery of new biomarkers in COPD. The division that Dr Celli works in has received grants for the participation in the development of biologic lung volume reduction surgery from the company AERIS. Dr Halbert serves as a consultant to the biotechnology/pharmaceutical industry, including makers of therapies for COPD.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

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