Peak Expiratory Flow Variability Adjusted by Forced Expiratory Volume in One Second is a Good Index for Airway Responsiveness in Asthmatics

Kazuto Matsunaga; Masae Kanda; Atsushi Hayata; Satoru Yanagisawa; Tomohiro Ichikawa; Keiichiro Akamatsu; Akira Koarai; Tsunahiko Hirano; Hisatoshi Sugiura; Yoshiaki Minakata; Masakazu Ichinose

doi:10.2169/internalmedicine.47.0855

ORIGINAL ARTICLES

Peak Expiratory Flow Variability Adjusted by Forced Expiratory Volume in One Second is a Good Index for Airway Responsiveness in Asthmatics

Kazuto Matsunaga, Masae Kanda, Atsushi Hayata, Satoru Yanagisawa, Tomohiro Ichikawa, Keiichiro Akamatsu, Akira Koarai, Tsunahiko Hirano, Hisatoshi Sugiura, Yoshiaki Minakata, Masakazu Ichinose

Author information

Kazuto Matsunaga
The Third Department of Internal Medicine, Wakayama Medical University, School of Medicine
Masae Kanda
The Third Department of Internal Medicine, Wakayama Medical University, School of Medicine
Atsushi Hayata
The Third Department of Internal Medicine, Wakayama Medical University, School of Medicine
Satoru Yanagisawa
The Third Department of Internal Medicine, Wakayama Medical University, School of Medicine
Tomohiro Ichikawa
The Third Department of Internal Medicine, Wakayama Medical University, School of Medicine
Keiichiro Akamatsu
The Third Department of Internal Medicine, Wakayama Medical University, School of Medicine
Akira Koarai
The Third Department of Internal Medicine, Wakayama Medical University, School of Medicine
Tsunahiko Hirano
The Third Department of Internal Medicine, Wakayama Medical University, School of Medicine
Hisatoshi Sugiura
The Third Department of Internal Medicine, Wakayama Medical University, School of Medicine
Yoshiaki Minakata
The Third Department of Internal Medicine, Wakayama Medical University, School of Medicine
Masakazu Ichinose
The Third Department of Internal Medicine, Wakayama Medical University, School of Medicine

Keywords: airway hyperresponsiveness, airway lability, airflow limitation, bronchial asthma, spirometry

JOURNAL OPEN ACCESS

2008 Volume 47 Issue 12 Pages 1107-1112

DOI https://doi.org/10.2169/internalmedicine.47.0855

Details

Abstract

Background The lowest peak expiratory flow (PEF) over a week, expressed as a percentage of the highest PEF (Min%Max PEF) has been reported to be the index that most closely correlates with airway hyperresponsiveness (AHR) in asthmatics. However, both fluctuation of the airway caliber and airflow limitation are regarded as physiological properties of asthma closely related to AHR. An accurate index that shows the degree of AHR may be obtained by combining the index of airway lability with the parameters that represent airway caliber.
Methods Ninety-two steroid-naive and twenty-eight steroid-treated asthmatic patients were enrolled. Using the physiological parameters obtained from spirometry and PEF monitoring, we investigated the indices which correlate accurately with airway responsiveness measured by the inhalation challenge test.
Results Although the methacholine threshold was related to all parameters that represent airway caliber and lability, Min%Max PEF had the strongest correlation with AHR. When Min%Max PEF was adjusted by the airway geometric factors, the normalization of Min%Max PEF with forced expiratory volume in one second as a percentage of the predicted value (%FEV₁) improved the relationship between Min%Max PEF and AHR.
Conclusions Min%Max PEF adjusted by %FEV₁ showed a good correlation with airway responsiveness measured by the inhalation challenge test, and may be useful as a convenient alternative index of AHR in asthmatic patients

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