Usefulness of the forced oscillation technique in diagnosing asthma-COPD overlap syndrome
Toshihiro Shirai (Shizuoka, Japan), Toshihiro Shirai, Keita Hirai, Taisuke Akamatsu, Takahito Suzuki, Ichiro Hayashi, Akito Yamamoto, Takefumi Akita, Satoru Morita, Kazuhiro Asada
Source: International Congress 2016 – From cardiopulmonary interaction to locomotor muscles and dyspnoea in health and disease
Disease area: Airway diseases
Abstract Introduction: Distinguishing asthma from COPD, especially in smokers and older adults, can be difficult; hence, determining clinical parameters that differentiate asthma, asthma-COPD overlap syndrome (ACOS), and COPD is essential to achieve successful treatment.Aims and objectives: We hypothesized that the forced oscillation technique (FOT) could differentiate ACOS form asthma and COPD. In this cross-sectional study, we assessed the usefulness of FOT in diagnosing ACOS.Methods: Spirometry, FOT (MostGraph-01), and fractional exhaled nitric oxide (FeNO) measurement were performed in asthma (117), ACOS (41), and COPD (44) patients. Asthma patients fulfilled the definition of GINA guidelines (regardless of FEV1/FVC values; smoking history, <10 pack-years). COPD patients fulfilled the definition of GOLD guidelines (FEV1/FVC, <0.7; smoking history, ³ 10 pack-years). ACOS was diagnosed if asthma patients had FEV1/FVC <0.7 and smoking history ³ 10 pack-years or COPD patients had FEV1/FVC <0.7 and FeNO >50 ppb without receiving inhaled corticosteroids.Results: ROC curve analyses for diagnosing asthma and COPD revealed that the areas under the curve of resistance at 20 Hz (R20) and the difference between inspiratory and expiratory reactance at 5 Hz (D X5) were largest (0.632 and 0.720, respectively) with the best cut-off values (2.710 and 0.221 cmH₂O/L/s, respectively). The accuracy of the diagnosis of ACOS based on these cut-off values (R20 <2.710 and D X5 <0.221 cmH₂O/L/s) was as follows: odds ratio, 3.97; 95% confidence interval, 1.84 to 8.72; sensitivity 58.5%; and specificity, 87.5%.Conclusions: Combined assessment of resistance and reactance may be useful in diagnosing ACOS.
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Toshihiro Shirai (Shizuoka, Japan), Toshihiro Shirai, Keita Hirai, Taisuke Akamatsu, Takahito Suzuki, Ichiro Hayashi, Akito Yamamoto, Takefumi Akita, Satoru Morita, Kazuhiro Asada. Usefulness of the forced oscillation technique in diagnosing asthma-COPD overlap syndrome. Eur Respir J 2016; 48: Suppl. 60, 5024
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