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European Journal of Medical Research

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01-12-2009 | Research

Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests

Authors: F Nensa, W Marek, E Marek, HJ Smith, M Kohlhäufl

Published in: European Journal of Medical Research | Special Issue 4/2009

Abstract

Introduction

Bronchial challenge tests by inhalation of aerosolized methacholine (MCH) are commonly used in the clinical diagnosis of airway hyperresponsiveness (AHR). While the detection of airway narrowing relies on the patient's cooperation performing forced spirometry, body plethysmographic measurements of airway resistance are less depending on the patient's cooperation and do not alter the respiratory tract by maximal maneuvers. Hence we compared both methods concerning their clinical value and correlation during MCH challenges in patients with asthma.

Materials and Methods

Cumulative MCH challenges test, consisting of up to 5 steps, evaluated with body plethysmography on each step were performed in 155 patients with bronchial asthma. Airway responses were recorded at each step of MCH application (Master-Screen Body, Cardinal Health, Höchberg). At the baseline test and after crossing the provocation dose (PD) threshold in body plethysmography (PD+100 sReff), forced expirations were performed and FEV₁, FVC, and FEV₁ %FVC were measured. Using regression analysis of the airway parameters and taking the MCH dose as the covariate, we could extrapolate to missing spirometric values and interpolate the estimated MCH dose when crossing the PD threshold (PD-20 FEV₁) between two consecutive measurements. The administered PD+100 MCH doses for specific airway resistance, sRtot, and sReff were compared with resistance parameters Rtot and Reff, and to PD-20 of FEV₁ and FEV₁ %FVC.

Results

Regarding sReff we found a mild, moderate, or severe AHR in 114 patients (75%), but only 50 (32%) according to FEV₁. A statistical analysis showed strongly linear correlated parameters of airway resistance, but no significant correlation between the results of body plethysmography and forced spirometry

Conclusions

Using MCH challenges, we found specific airway resistance to be the most sensitive parameter to detect AHR. Raw is largely independent of height and gender facilitating the interpretation of measurements carried out longitudinally.

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Title: Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests
Authors: F Nensa
W Marek
E Marek
HJ Smith
M Kohlhäufl
Publication date: 01-12-2009
Publisher: BioMed Central
Published in: European Journal of Medical Research / Issue Special Issue 4/2009
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/2047-783X-14-S4-170

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests

Abstract

Introduction

Materials and Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and Methods

Results

Conclusions

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