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Impulse oscillometry for leukotriene D4 inhalation challenge in asthma.
Respir Care 2013; 58(12):2120-6RC

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.

Authors+Show Affiliations

State Key Laboratory of Respiratory Disease, China Clinical Research Center for Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23716710

Citation

Guan, Wei Jie, et al. "Impulse Oscillometry for Leukotriene D4 Inhalation Challenge in Asthma." Respiratory Care, vol. 58, no. 12, 2013, pp. 2120-6.
Guan WJ, Zheng JP, Gao Y, et al. Impulse oscillometry for leukotriene D4 inhalation challenge in asthma. Respir Care. 2013;58(12):2120-6.
Guan, W. J., Zheng, J. P., Gao, Y., Jiang, C. Y., Shi, X., Xie, Y. Q., ... Zhong, N. S. (2013). Impulse oscillometry for leukotriene D4 inhalation challenge in asthma. Respiratory Care, 58(12), pp. 2120-6. doi:10.4187/respcare.02417.
Guan WJ, et al. Impulse Oscillometry for Leukotriene D4 Inhalation Challenge in Asthma. Respir Care. 2013;58(12):2120-6. PubMed PMID: 23716710.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impulse oscillometry for leukotriene D4 inhalation challenge in asthma. AU - Guan,Wei Jie, AU - Zheng,Jin Ping, AU - Gao,Yi, AU - Jiang,Cai Yu, AU - Shi,Xu, AU - Xie,Yan Qing, AU - Liu,Qing Xia, AU - Jiang,Mei, AU - An,Jia Ying, AU - Yu,Xin Xin, AU - Liu,Wen Ting, AU - Zhong,Li Ping, AU - Wu,Zhong Ping, AU - Zhong,Nan Shan, Y1 - 2013/05/28/ PY - 2013/5/30/entrez PY - 2013/5/30/pubmed PY - 2014/8/19/medline KW - airway resistance KW - asthma KW - bronchial provocation test KW - impulse oscillometry KW - leukotriene D4 KW - resonance frequency SP - 2120 EP - 6 JF - Respiratory care JO - Respir Care VL - 58 IS - 12 N2 - 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. SN - 1943-3654 UR - https://www.unboundmedicine.com/medline/citation/23716710/Impulse_oscillometry_for_leukotriene_D4_inhalation_challenge_in_asthma_ L2 - http://rc.rcjournal.com/cgi/pmidlookup?view=short&pmid=23716710 DB - PRIME DP - Unbound Medicine ER -