Source: International Congress 2015 – Lung function: exploring the boundaries of the respiratory system
Disease area: Airway diseases

Abstract

IntroductionA bronchial challenge test (BCT) with inhalation of histamine is used to test for airway hyperresponsiveness (AHR), however the measured forced expiratory volume in one second (FEV1) is effort-related. Assessing specific airway resistance (sRaw) is a more effort-independent procedure, however little is known about the correlation between FEV1 and sRaw.Aims and objectivesOur hypothesis is that assessing sRaw adds information to a BCT possibly leading to increased sensitivity in excluding asthma.MethodsAll patients seen on the outpatient clinic with respiratory symptoms suggestive of asthma who performed a BCT using histamine were included in the study. Bronchial reactivity was defined as the provocative dosage/concentration at which a 20% decline in FEV1 was seen (PC20), or at which the airway resistance increased with 100% up to 200% (PC200).Results119 patients were evaluated, of which 15 were excluded due to insufficient data. 42 patients (40%) showed no significant response in FEV1 and sRaw, of which 21 had recognizable symptoms. 27 (26%) only had a positive response for sRaw, without a significant fall in FEV1. 26 reported recognizable symptoms. 3 patients (3%) had a response in FEV1 without showing an increase in sRaw. The remaining 32 patients (31%) had both a positive PC20 and PC200, all reporting recognizable symptoms.ConclusionWe found 27 patients (26%) with a significant increase in sRaw without a fall in FEV1, while reporting recognizable symptoms. Not measuring sRaw would wrongly exclude a diagnosis of asthma. This research suggests adding sRaw to FEV1 increases the sensitivity of BCT for AHR.


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Florine J.E. van der Horst-van der Vegt (Gravenhage, Netherlands), Florine Van der Horst, Jelmer Vahl, Saar Van Nederveen, Guustaaf Van der Meijden, Harry Heijerman. FEV1 and sRaw in bronchial challenge testing, exchangeable or supplementaFEV1 and sRaw in bronchial challenge testing, exchangeable or supplemental?. Eur Respir J 2015; 46: Suppl. 59, 947

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