Late Breaking Abstract - Oscillometry to Predict FEV₁ Decline and Incidental Abnormal Spirometry in Smokers with Initially Normal Spirometry

Abdo, Mustafa; Watz, Henrik; Ewert, Ralf; Obst, Anne; Völzke, Henry ; Flexeder, Claudia ; Heier, Margit ; Peters, Annette ; Herth, Felix ; Trinkmann, Frederik; Rabe, Klaus F. ; Stubbe, Beate und Karrasch, Stefan (2025): Late Breaking Abstract - Oscillometry to Predict FEV₁ Decline and Incidental Abnormal Spirometry in Smokers with Initially Normal Spirometry. ERS: European Respiratory Society Congress 2025, Amsterdam, 27. September - 01. Oktober 2025. Chalmers, James D. (ed.) : European Respiratory Journal. Vol. 66, No. Supplement 69, OA6432 Sheffield: European Respiratory Society.

Abstract

Background: Oscillometry provides a sensitive measure of airway resistance, a surrogate of airflow obstruction. We investigated whether oscillometry predicts accelerated FEV₁ decline and future abnormal spirometry in smokers with initially normal spirometry.

Methods: Current and former smokers (35–65 y) with normal baseline spirometry (FEV₁/FVC ≥ 0.70 and FEV₁ ≥ 80% predicted) and no known airway disease were included from two population-based cohorts (KORA, SHIP). Subjects were stratified by baseline resistance at 5 Hz (R5) relative to the upper limit of normal: normal (R5 ≤ ULN) vs. high (R5 > ULN). We compared annual FEV₁ decline and incident abnormal spirometry (FEV₁/FVC < 0.70 or FEV₁ < 80%) between groups.

Results: In both cohorts, 17% of smokers had high R5 despite normal spirometry. These subjects showed greater mean annual FEV₁ decline (mL/year) vs. those with normal R5 (KORA: 139±70 vs. 96±70, p=0.002; SHIP: 111±130 vs. 53±80, p=0.034). A pooled analysis (median FU: 44 months) showed a 6-fold higher risk of abnormal spirometry in the high-R5 group (Fig. 1), after adjusting for smoking status, chronic bronchitis, and baseline FEV₁ and FVC. Of 61 subjects who developed abnormal spirometry, 50 showed airflow obstruction.

Conclusion: High airway resistance on oscillometry predicts accelerated FEV₁ decline and future abnormal spirometry, supporting its role in early COPD risk stratification.

• Item Type: Conference or Workshop Item (Abstract)
• Faculties: Medicine > Institute and Polyclinic for Occupational, Social and Environmental Medicine
• Subjects: 600 Technology > 610 Medicine and health
• Place of Publication: Sheffield
• Language: English