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The study examines whether spirometry-defined restrictive components, including restrictive and mixed ventilatory defects, alter acute exacerbation risk. Methods: A prospective cohort from 51 Korean referral hospitals classified patients into normal, OVD, RVD, and MVD groups and compared AE incidence rate ratios using the normal group as 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was the main research question of the study?","Question",{"text":113,"@type":114},"Whether spirometry-defined restrictive components modify the association between lung function measures and acute exacerbation risk in patients with bronchiectasis.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were participants classified in the prospective cohort?",{"text":118,"@type":114},"Patients were grouped as normal, obstructive ventilatory defect (OVD), restrictive ventilatory defect (RVD), or mixed ventilatory defect (MVD) using FEV1/FVC and FVC relative to the lower limit of normal.",{"name":120,"@type":111,"acceptedAnswer":121},"Which spirometry parameters were associated with increased AE risk?",{"text":122,"@type":114},"Lower FVC and FEV1 were associated with higher risk of any and severe AE within RVD and MVD groups, and restrictive components modified the effect of FVC (not FEV1) on AE 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Capacity and Bronchiectasis Exacerbation  \nJang Ho Lee1,*, Hyun Lee2,*, Seonok Kim3, Bumhee Yang4, Hayoung Choi5, Chin Kook Rhee6, Yong Bum Park7, Yeon-Mok Oh1, Seung Won Ra8 and KMBARC investigators and Korean Bronchiectasis Study Group 1Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 2Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 3Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 4Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chungbuk National University Hospital, Cheongju, 5Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, 6Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, 7Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, 8Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea  \nAbstract  \nBackground: Obstructive ventilatory defect (OVD) is the most common ventilatory pattern in bronchiectasis, with low forced expiratory volume in 1 second (FEV1), which is a well-known risk factor for acute exacerbation (AE) . However, the impact of spirometry-defined restrictive components (restrictive ventilatory defects [RVD] or mixed ventilatory defects [MVD]) on AE remains unreported. This study evaluated the association between spirometry-defined restrictive components and AE risk in patients with bronchiectasis.  \nMethods: In this prospective cohort study, patients from 51 referral hospitals in the Republic of Korea were classified into the normal (FEV1/forced vital capacity (FVC) ≥ lower limit of normal [LLN] and FVC≥LLN, n=62), OVD (FEV1/FVC\u003CLLN and FVC≥LLN, n=59), RVD (FEV1/FVC≥LLN and FVC\u003CLLN, n=148), and MVD (FEV1/FVC\u003CLLN and FVC\u003CLLN, n=223) groups. Incidence rate ratios (IRRs) of AE associated with ventilatory defects were compared using the normal group as a reference group.  \nResults: The MVD group had the highest annual severe AE IRR (3 . 557; 95% confidence interval [CI], 0.918 to 17.851), followed by the RVD (2 .678; 95% CI, 0.704 to 13.422) and OVD groups (1 .926; 95% CI, 0.379 to 11.430) (p for trend=0 .051) compared to the normal group. Lower FVC and FEV₁ were significantly associated with increased risk of any AE and severe AE in the RVD and MVD groups. The spirometry-defined restrictive component significantly affected the relationships of any AE and severe AE with FVC (p for interaction \u003C0 .05), not with FEV1.  \nConclusion: The presence of a spirometry-defined restrictive component was associated with higher annual rates for any AE and severe AE, which modified the FVC, not FEV1, effect on the risk for such events.  \nKeywords: Bronchiectasis; Exacerbation; Ventilatory Defect  \n[https://doi.org/10.4046/trd.2024.0187](https://doi.org/10.4046/trd.2024.0187)  \nISSN: 1738-3536(Print)/ 2005-6184(Online)  \nTuberc Respir Dis 2026;89:102-113  \nCopyright © 2026 The Korean Academy of Tuberculosis and Respiratory Diseases  \nAddress for correspondence Seung Won Ra  \nDivision of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 25 Daehakbyeongwonro, Dong-gu, Ulsan 44033, Republic of Korea  \nPhone 82-2-250-8857  \nFax 82-2-250-7048  \n[E-mail](E-mail docra@uuh.ulsan.kr)[ docra@uuh.ulsan.kr](E-mail docra@uuh.ulsan.kr)","cbCaia2pZQi5Twko","https://ap.wps.com/l/cbCaia2pZQi5Twko","pdf",680305,12,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction\n## Bronchiectasis phenotypes and ventilatory defects\n## Acute exacerbation relevance","[{\"question\":\"What was the main research question of the study?\",\"answer\":\"Whether spirometry-defined restrictive components modify the association between lung function measures and acute exacerbation risk in patients with bronchiectasis.\"},{\"question\":\"How were participants classified in the prospective cohort?\",\"answer\":\"Patients were grouped as normal, obstructive ventilatory defect (OVD), restrictive ventilatory defect (RVD), or mixed ventilatory defect (MVD) using FEV1/FVC and FVC relative to the lower limit of normal.\"},{\"question\":\"Which spirometry parameters were associated with increased AE risk?\",\"answer\":\"Lower FVC and FEV1 were associated with higher risk of any and severe AE within RVD and MVD groups, and restrictive components modified the effect of FVC (not FEV1) on AE risk.\"}]","Spirometry-Defined Restriction Modifies the Association between Forced Vital Capacity and Bronchiectasis Exacerbation | PDF",1790757326]