Spirometric Response to Bronchodilator and Eucapnic Voluntary Hyperpnea in Adults With Asthma.
BACKGROUND: The spirometric response to fast-acting bronchodilator is used clinically to diagnose asthma and in clinical research to verify its presence. However, bronchodilator responsiveness does not correlate with airway hyper-responsiveness measured with the direct-acting stimulus of methacholin...
| Publicado en: | Respiratory Care Vol. 66; no. 8; pp. 1282 - 1291 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Aug2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=151671548&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 151671548 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Aug2021 vid: 66 iid: 8 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 151671548 151671548 151671548 10.4187/respcare.08421 151671548 ppf: 1282 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Spirometric Response to Bronchodilator and Eucapnic Voluntary Hyperpnea in Adults With Asthma. aug: au: Haverkamp, Hans Christian Kaminsky, David A. McPherson, Sterling M. Irvin, Charles G. affil: Department of Nutrition and Exercise Physiology, Washington State University-Health Sciences Spokane, Elson S. Floyd College of Medicine, Spokane, Washington sug: subj: Asthma Drug Therapy Bronchodilator Agents Therapeutic Use Respiratory Hypersensitivity Human Female Male Adult Spirometry Retrospective Design Research Subject Recruitment Consent (Research) Forced Expiratory Volume Forced Expiratory Flow Rates Bronchoconstriction Body Mass Index Descriptive Statistics Kruskal-Wallis Test Matched-Pair Analysis Mann-Whitney U Test Post Hoc Analysis T-Tests Pearson's Correlation Coefficient Correlation Coefficient Statistical Significance Data Analysis Software Adult: 19-44 years Female Male ab: BACKGROUND: The spirometric response to fast-acting bronchodilator is used clinically to diagnose asthma and in clinical research to verify its presence. However, bronchodilator responsiveness does not correlate with airway hyper-responsiveness measured with the direct-acting stimulus of methacholine, demonstrating that bronchodilator responsiveness is a problematic method for diagnosing asthma. The relationship between bronchodilator responsiveness and airway hyper-responsiveness assessed with indirect-acting stimuli is not known. METHODS: Retrospectively, the spirometric responses to inhaled bronchodilator and a eucapnic voluntary hyperpnea challenge (EVH) were compared in 39 non-smoking adult subjects with asthma (26 male, 13 female; mean ± SD age 26.9 ± 7.8 y; mean ± SD body mass index 26.3 ± 4.7 kg/m²). All subjects met one or both of 2 criteria: ≥ 12% and 200 mL increase in FEV1 after inhaled bronchodilator, and ≥ 10% decrease in FEV1 after an EVH challenge. RESULTS: Overall, FEV1 increased by 9.9 ≥ 7.9% after bronchodilator (3.93 ± 0.97 to 4.28 ± 0.91 L, P < .001) and decreased by 23.9 ± 15.0% after the EVH challenge (3.89 ± 0.89 to 2.96 6 0.88 L, P < .001). However, the change in FEV1 after bronchodilator did not correlate with the change after EVH challenge (r = 0.062, P = .71). Significant bronchodilator responsiveness predicted a positive response to EVH challenge in 9 of 33 subjects (sensitivity 27%). Following EVH, the change in FEV1 strongly correlated with the change in FVC (FEV1 percent change vs FVC percent change, r = 0.831, P < .001; FEV1 DL vs FVC DL, r = 0.799, P < .001). CONCLUSIONS: These results extend previous findings that demonstrate a lack of association between bronchodilator responsiveness and methacholine responsiveness. Given the poor concordance between the spirometric response to fast-acting bronchodilator and the EVH challenge, these findings suggest that the airway response to inhaled β2-agonist must be interpreted with caution and in the context of its determinants and limitations. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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