The Usefulness of FEF25–75 in Predicting Airway Hyperresponsiveness to Mannitol
Youlim Kim,1,* Hyun Lee,2,* Sung Jun Chung,2,* Yoomi Yeo,2 Tai Sun Park,2 Dong Won Park,2 Kyung Hoon Min,3 Sang-Heon Kim,2 Tae-Hyung Kim,2 Jang Won Sohn,2 Ji-Yong Moon,2 Ho Joo Yoon2 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine,...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2021-10-01
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| Series: | Journal of Asthma and Allergy |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-usefulness-of-fef2575-in-predicting-airway-hyperresponsiveness-to--peer-reviewed-fulltext-article-JAA |
| _version_ | 1818741919970230272 |
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| author | Kim Y Lee H Chung SJ Yeo Y Park TS Park DW Min KH Kim SH Kim TH Sohn JW Moon JY Yoon HJ |
| author_facet | Kim Y Lee H Chung SJ Yeo Y Park TS Park DW Min KH Kim SH Kim TH Sohn JW Moon JY Yoon HJ |
| author_sort | Kim Y |
| collection | DOAJ |
| description | Youlim Kim,1,* Hyun Lee,2,* Sung Jun Chung,2,* Yoomi Yeo,2 Tai Sun Park,2 Dong Won Park,2 Kyung Hoon Min,3 Sang-Heon Kim,2 Tae-Hyung Kim,2 Jang Won Sohn,2 Ji-Yong Moon,2 Ho Joo Yoon2 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University Hospital, School of Medicine, Konkuk University, Seoul, Korea; 2Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea; 3Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Medical Center, Guro Hospital, Seoul, Korea*These authors contributed equally to this workCorrespondence: Ji-Yong MoonDepartment of Internal Medicine, Hanyang University Guri Hospital, Gyeongchun-ro 153, Guri-si, Gyeonggi-do, 11923, KoreaTel +82-31-560-2224Fax +82-31-553-7369Email respiry@gmail.comHo Joo YoonDivision of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, 04763, KoreaTel +82-2-2290-8336Fax +82-2-2298-9183Email hjyoon@hanyang.ac.krBackground and Objective: Despite the usefulness of airway hyperresponsiveness (AHR) testing in diagnosing and monitoring asthma, it is challenging to perform in a real-world setting. Forced expiratory flow between 25% and 75% of vital capacity (FEF25– 75), a pulmonary measurement that can be obtained easily during routine spirometry, represents the status of medium-sized and small airways. However, the performance of FEF25– 75 in predicting AHR has not been well elucidated. Therefore, we investigated whether FEF25– 75 can predict AHR to mannitol.Methods: We performed a retrospective cohort study of 428 patients who visited a single clinic due to cough, wheezing, or dyspnea. All patients underwent spirometry with a mannitol provocation test. We compared the area under the curve (AUC) of the percentage of the predicted values of FEF25– 75 (FEF25– 75 %pred) with that of forced expiratory volume in 1 second (FEV1%pred), FEV1/forced vital capacity (FVC), and FEF25– 75/ FVC for predicting AHR.Results: The rate of AHR to mannitol was 20.3%. In the overall study population, the AUC of FEF25– 75 %pred for predicting AHR (0.772; 95% confidence interval [CI], 0.729– 0.811) was significantly higher than that of FEV1%pred (0.666; 95% CI, 0.619– 0.710; p < 0.001), FEV1/FVC (0.741; 95% CI, 0.697– 0.782; p = 0.047), and FEF25– 75/FVC (0.741, 95% CI = 0.696– 0.782, p = 0.046). The sensitivity, specificity, positive predictive value, and negative predictive value of FEF25– 75 %pred < 81% for predicting AHR in the overall study population were 77.0% (95% CI = 66.8– 85.4%), 63.9% (95% CI = 58.6– 69.0), 35.3%, and 91.6%, respectively. When we restricted the study group to subjects with normal lung function, the results were similar.Conclusion: Our results indicate that FEF25– 75 %pred can be used as a surrogate for predicting AHR in patients with respiratory symptoms.Keywords: forced expiratory flow between 25% and 75% of vital capacity, mannitol, bronchial hyperresponsiveness |
| first_indexed | 2024-12-18T02:04:17Z |
| format | Article |
| id | doaj.art-da5d52770ac14e0ca69f0b71a7b29cfa |
| institution | Directory Open Access Journal |
| issn | 1178-6965 |
| language | English |
| last_indexed | 2024-12-18T02:04:17Z |
| publishDate | 2021-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Asthma and Allergy |
| spelling | doaj.art-da5d52770ac14e0ca69f0b71a7b29cfa2022-12-21T21:24:40ZengDove Medical PressJournal of Asthma and Allergy1178-69652021-10-01Volume 141267127570083The Usefulness of FEF25–75 in Predicting Airway Hyperresponsiveness to MannitolKim YLee HChung SJYeo YPark TSPark DWMin KHKim SHKim THSohn JWMoon JYYoon HJYoulim Kim,1,* Hyun Lee,2,* Sung Jun Chung,2,* Yoomi Yeo,2 Tai Sun Park,2 Dong Won Park,2 Kyung Hoon Min,3 Sang-Heon Kim,2 Tae-Hyung Kim,2 Jang Won Sohn,2 Ji-Yong Moon,2 Ho Joo Yoon2 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University Hospital, School of Medicine, Konkuk University, Seoul, Korea; 2Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea; 3Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Medical Center, Guro Hospital, Seoul, Korea*These authors contributed equally to this workCorrespondence: Ji-Yong MoonDepartment of Internal Medicine, Hanyang University Guri Hospital, Gyeongchun-ro 153, Guri-si, Gyeonggi-do, 11923, KoreaTel +82-31-560-2224Fax +82-31-553-7369Email respiry@gmail.comHo Joo YoonDivision of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, 04763, KoreaTel +82-2-2290-8336Fax +82-2-2298-9183Email hjyoon@hanyang.ac.krBackground and Objective: Despite the usefulness of airway hyperresponsiveness (AHR) testing in diagnosing and monitoring asthma, it is challenging to perform in a real-world setting. Forced expiratory flow between 25% and 75% of vital capacity (FEF25– 75), a pulmonary measurement that can be obtained easily during routine spirometry, represents the status of medium-sized and small airways. However, the performance of FEF25– 75 in predicting AHR has not been well elucidated. Therefore, we investigated whether FEF25– 75 can predict AHR to mannitol.Methods: We performed a retrospective cohort study of 428 patients who visited a single clinic due to cough, wheezing, or dyspnea. All patients underwent spirometry with a mannitol provocation test. We compared the area under the curve (AUC) of the percentage of the predicted values of FEF25– 75 (FEF25– 75 %pred) with that of forced expiratory volume in 1 second (FEV1%pred), FEV1/forced vital capacity (FVC), and FEF25– 75/ FVC for predicting AHR.Results: The rate of AHR to mannitol was 20.3%. In the overall study population, the AUC of FEF25– 75 %pred for predicting AHR (0.772; 95% confidence interval [CI], 0.729– 0.811) was significantly higher than that of FEV1%pred (0.666; 95% CI, 0.619– 0.710; p < 0.001), FEV1/FVC (0.741; 95% CI, 0.697– 0.782; p = 0.047), and FEF25– 75/FVC (0.741, 95% CI = 0.696– 0.782, p = 0.046). The sensitivity, specificity, positive predictive value, and negative predictive value of FEF25– 75 %pred < 81% for predicting AHR in the overall study population were 77.0% (95% CI = 66.8– 85.4%), 63.9% (95% CI = 58.6– 69.0), 35.3%, and 91.6%, respectively. When we restricted the study group to subjects with normal lung function, the results were similar.Conclusion: Our results indicate that FEF25– 75 %pred can be used as a surrogate for predicting AHR in patients with respiratory symptoms.Keywords: forced expiratory flow between 25% and 75% of vital capacity, mannitol, bronchial hyperresponsivenesshttps://www.dovepress.com/the-usefulness-of-fef2575-in-predicting-airway-hyperresponsiveness-to--peer-reviewed-fulltext-article-JAAforced expiratory flow between 25% and 75% of vital capacitymannitolbronchial hyperresponsiveness |
| spellingShingle | Kim Y Lee H Chung SJ Yeo Y Park TS Park DW Min KH Kim SH Kim TH Sohn JW Moon JY Yoon HJ The Usefulness of FEF25–75 in Predicting Airway Hyperresponsiveness to Mannitol Journal of Asthma and Allergy forced expiratory flow between 25% and 75% of vital capacity mannitol bronchial hyperresponsiveness |
| title | The Usefulness of FEF25–75 in Predicting Airway Hyperresponsiveness to Mannitol |
| title_full | The Usefulness of FEF25–75 in Predicting Airway Hyperresponsiveness to Mannitol |
| title_fullStr | The Usefulness of FEF25–75 in Predicting Airway Hyperresponsiveness to Mannitol |
| title_full_unstemmed | The Usefulness of FEF25–75 in Predicting Airway Hyperresponsiveness to Mannitol |
| title_short | The Usefulness of FEF25–75 in Predicting Airway Hyperresponsiveness to Mannitol |
| title_sort | usefulness of fef25 ndash 75 in predicting airway hyperresponsiveness to mannitol |
| topic | forced expiratory flow between 25% and 75% of vital capacity mannitol bronchial hyperresponsiveness |
| url | https://www.dovepress.com/the-usefulness-of-fef2575-in-predicting-airway-hyperresponsiveness-to--peer-reviewed-fulltext-article-JAA |
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