Abstract
BackgroundBronchodilator response in patients with asthma is evaluated based on post-bronchodilator increase in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). However, the need for additional parameters, mainly among patients with severe asthma, has already been demonstrated.MethodsThe aim of this study was to evaluate the usefulness of vital capacity (VC) and inspiratory capacity (IC) to evaluate bronchodilator response in asthma patients with persistent airflow obstruction. The 43 asthma patients enrolled in the study were stratified into moderate or severe airflow obstruction groups based on baseline FEV1. All patients performed a 6-minute walk test before and after the bronchodilator (BD). A bipolar visual analogue scale post-BD was performed to assess clinical effect. The correlation between VC and IC and clinical response, determined by visual analogue scale (VAS) and 6-minute walk test (6MWT), was investigated.ResultsPatients in the severe group presented: 1) greater bronchodilator response in VC (48% vs 15%, p = 0.02), 2) a significant correlation between VC variation and the reduction in air trapping (Rs = 0.70; p < 0.01), 3) a significant agreement between VC and VAS score (kappa = 0.57; p < 0.01). There was no correlation between IC and the reduction in air trapping or clinical data.ConclusionsVC may be a useful additional parameter to evaluate bronchodilator response in asthma patients with severe airflow obstruction.
Highlights
Bronchodilator response in patients with asthma is evaluated based on post-bronchodilator increase in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)
Spirometry, 6-minute walk test (6MWT), and visual analogue scale (VAS) were performed in all patients, while static lung volumes were analyzed in 37 patients
VC, inspiratory capacity (IC), FVC, and FEV1 were significantly lower in the group with severe airflow obstruction vs. the group with moderate airflow obstruction
Summary
Bronchodilator response in patients with asthma is evaluated based on post-bronchodilator increase in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). The need for additional parameters, mainly among patients with severe asthma, has already been demonstrated. A positive bronchodilator response is established based on an increase ≥ 12% and 200 ml in forced vital capacity (FVC) and/or forced expiratory volume in one second (FEV1) compared with baseline values following administration of bronchodilators [2]. In clinical practice, patients with moderate or severe asthma may refer clinical improvement. The aim of this study was to analyze the usefulness of VC and IC as additional parameters to assess bronchodilator response in asthma patients with moderate or severe airflow obstruction
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