Essential for the diagnosis and quantification of lung function impairment in COPD.

A marker of COPD progression and mortality.

Has a poor correlation with degree of dyspnea the patient experiences.

COPD characterized by an accelerated decline in FEV1.

Mean rate of change in COPD is a decline of 33+/_2 mL per year in a 3 year study with 38% having a decline in FEV1 of more than 40mL per year, 31% decline of 21-40 mL per year, 23% with decrease to increase of 20 mL per year and 8% with an increase of more than 30 mL per year (Vestbo J et al).

Increased rates in FEV1 decline associated with continued smoking, bronchdilator reversibility and in patients with emphysema.

Current smokers have the greatest rate of decline in FEV1.

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