{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T07:36:14Z","timestamp":1767339374502,"version":"3.48.0"},"reference-count":32,"publisher":"The Korean Academy of Tuberculosis and Respiratory Diseases","issue":"1","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-trd.org"],"crossmark-restriction":true},"short-container-title":["Tuberc Respir Dis"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:p>Background: Obstructive ventilatory defect (OVD) is the most common ventilatory pattern in bronchiectasis, with low forced expiratory volume in 1 second (FEV&lt;sub&gt;1&lt;\/sub&gt;), 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.Methods: In this prospective cohort study, patients from 51 referral hospitals in the Republic of Korea were classified into the normal (FEV&lt;sub&gt;1&lt;\/sub&gt;\/forced vital capacity (FVC) \u2265 lower limit of normal [LLN] and FVC\u2265LLN, n=62), OVD (FEV&lt;sub&gt;1&lt;\/sub&gt;\/FVC&lt;LLN and FVC\u2265LLN, n=59), RVD (FEV&lt;sub&gt;1&lt;\/sub&gt;\/FVC\u2265LLN and FVC&lt;LLN, n=148), and MVD (FEV&lt;sub&gt;1&lt;\/sub&gt;\/FVC&lt;LLN and FVC&lt;LLN, n=223) groups. Incidence rate ratios (IRRs) of AE associated with ventilatory defects were compared using the normal group as a reference group.Results: 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 FEV\u2081 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 &lt;0.05), not with FEV&lt;sub&gt;1&lt;\/sub&gt;.Conclusion: 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 FEV&lt;sub&gt;1&lt;\/sub&gt;, effect on the risk for such events.<\/jats:p>","DOI":"10.4046\/trd.2024.0187","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T08:06:46Z","timestamp":1762416406000},"page":"102-113","update-policy":"https:\/\/doi.org\/10.4046\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spirometry-Defined Restriction Modifies the Association between Forced Vital Capacity and Bronchiectasis Exacerbation"],"prefix":"10.4046","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8226-9585","authenticated-orcid":true,"given":"Jang 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