000063022 001__ 63022 000063022 005__ 20190709135514.0 000063022 0247_ $$2doi$$a10.2147/COPD.S132236 000063022 0248_ $$2sideral$$a101666 000063022 037__ $$aART-2017-101666 000063022 041__ $$aeng 000063022 100__ $$aRossi, A. 000063022 245__ $$aChronic obstructive pulmonary disease with mild airflow limitation: Current knowledge and proposal for future research – A consensus document from six scientific societies 000063022 260__ $$c2017 000063022 5060_ $$aAccess copy available to the general public$$fUnrestricted 000063022 5203_ $$aChronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity worldwide, with high and growing prevalence. Its underdiagnosis and hence under-treatment is a general feature across all countries. This is particularly true for the mild or early stages of the disease, when symptoms do not yet interfere with daily living activities and both patients and doctors are likely to underestimate the presence of the disease. A diagnosis of COPD requires spirometry in subjects with a history of exposure to known risk factors and symptoms. Postbronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity <0.7 or less than the lower limit of normal confirms the presence of airflow limitation, the severity of which can be measured by FEV1% predicted: stage 1 defines COPD with mild airflow limitation, which means postbronchodilator FEV1 =80% predicted. In recent years, an elegant series of studies has shown that “exclusive reliance on spirometry, in patients with mild airflow limitation, may result in underestimation of clinically important physiologic impairment”. In fact, exercise tolerance, diffusing capacity, and gas exchange can be impaired in subjects at a mild stage of airflow limitation. Furthermore, growing evidence indicates that smokers without overt abnormal spirometry have respiratory symptoms and undergo therapy. This is an essential issue in COPD. In fact, on one hand, airflow limitation, even mild, can unduly limit the patient’s physical activity, with deleterious consequences on quality of life and even survival; on the other hand, particularly in younger subjects, mild airflow limitation might coincide with the early stage of the disease. Therefore, we thought that it was worthwhile to analyze further and discuss this stage of “mild COPD”. To this end, representatives of scientific societies from five European countries have met and developed this document to stimulate the attention of the scientific community on COPD with “mild” airflow limitation. The aim of this document is to highlight some key features of this important concept and help the practicing physician to understand better what is behind “mild” COPD. Future research should address two major issues: first, whether mild airflow limitation represents an early stage of COPD and what the mechanisms underlying the evolution to more severe stages of the disease are; and second, not far removed from the first, whether regular treatment should be considered for COPD patients with mild airflow limitation, either to prevent progression of the disease or to encourage and improve physical activity or both. 000063022 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc$$uhttp://creativecommons.org/licenses/by-nc/3.0/es/ 000063022 590__ $$a2.917$$b2017 000063022 591__ $$aRESPIRATORY SYSTEM$$b25 / 59 = 0.424$$c2017$$dQ2$$eT2 000063022 592__ $$a1.395$$b2017 000063022 593__ $$aHealth Policy$$c2017$$dQ1 000063022 593__ $$aPulmonary and Respiratory Medicine$$c2017$$dQ1 000063022 593__ $$aPublic Health, Environmental and Occupational Health$$c2017$$dQ1 000063022 593__ $$aMedicine (miscellaneous)$$c2017$$dQ1 000063022 655_4 $$ainfo:eu-repo/semantics/review$$vinfo:eu-repo/semantics/publishedVersion 000063022 700__ $$aButorac-Petanjek, B. 000063022 700__ $$aChilosi, M. 000063022 700__ $$aCosío, B.G. 000063022 700__ $$aFlezar, M. 000063022 700__ $$aKoulouris, N. 000063022 700__ $$0(orcid)0000-0001-9096-2294$$aMarin, J.$$uUniversidad de Zaragoza 000063022 700__ $$aMiculinic, N. 000063022 700__ $$aPolese, G. 000063022 700__ $$aSamaržija, M. 000063022 700__ $$aSkrgat, S. 000063022 700__ $$aVassilakopoulos, T. 000063022 700__ $$aVukic-Dugac, A. 000063022 700__ $$aZakynthinos, S. 000063022 700__ $$aMiravitlles, M. 000063022 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina 000063022 773__ $$g12 (2017), 2593-2610$$pInt. j. chronic obstr. pulm. dis.$$tInternational journal of chronic obstructive pulmonary disease$$x1176-9106 000063022 8564_ $$s810847$$uhttps://zaguan.unizar.es/record/63022/files/texto_completo.pdf$$yVersión publicada 000063022 8564_ $$s66849$$uhttps://zaguan.unizar.es/record/63022/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000063022 909CO $$ooai:zaguan.unizar.es:63022$$particulos$$pdriver 000063022 951__ $$a2019-07-09-11:53:37 000063022 980__ $$aARTICLE