Impulse oscillometry for leukotriene D4 inhalation challenge in asthma.

Abstract:

BACKGROUND:The value of impulse oscillometry (IOS) for bronchial provocation testing is poorly defined. We investigated the positive threshold derived from the parameters and diagnostic power of IOS for asthma with the leukotriene D(4) bronchial provocation test. METHODS:We enrolled 62 subjects with asthma and 21 healthy subjects. IOS was employed to perform the leukotriene D(4) bronchial provocation test, followed by spirometry. The positive threshold was determined based on the cutoff point in the receiver operating characteristic curve, from which the parameters with the highest diagnostic power were obtained. RESULTS:Airway impedance at 5 Hz (Z(5)), resistance at 5 Hz (R(5)), and resonance frequency had the highest diagnostic power (areas under curve 0.82, 0.82, and 0.81, respectively), with increases of 57%, 43%, and 63%, corresponding to a 20% decrease in FEV(1), respectively. IOS indices yielded assay sensitivity and specificity similar to that of spirometry. The positive threshold for IOS, defined as either a 57% increase in Z(5) or a 63% increase in resonance frequency in the bronchial provocation test, yielded an assay accuracy of 0.6 in subjects with asthma. CONCLUSIONS:IOS during the leukotriene D(4) bronchial provocation test has a diagnostic power similar to that of spirometry. Either a 57% increase in Z(5) or a 63% increase in resonance frequency may be regarded as a surrogate of FEV(1) decrease to determine airway hyper-responsiveness in asthma.

journal_name

Respir Care

journal_title

Respiratory care

authors

Guan WJ,Zheng JP,Gao Y,Jiang CY,Shi X,Xie YQ,Liu QX,Jiang M,An JY,Yu XX,Liu WT,Zhong LP,Wu ZP,Zhong NS

doi

10.4187/respcare.02417

subject

Has Abstract

pub_date

2013-12-01 00:00:00

pages

2120-6

issue

12

eissn

0020-1324

issn

1943-3654

pii

respcare.02417

journal_volume

58

pub_type

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