Reversibility Test in the Early Stages of Bronchial Asthma

Abstract

In the early stages of bronchial asthma, it is frequent to find subjects with a positive history and an FEV 1 or FEV 1 /FVC > 80% of the predicted value. This study investigated if the test of reversibility showed a reversible airway obstruction (RAO) in 291 subjects with the above clinical and functional features. Forced expiratory volume in 1 second (FEV 1 ), forced vital capacity (FVC), and expiratory flows (PEF, MEF 50 , FEF 25 -75 ) were registered before and 20 minutes after salbutamol administration (200 mcg by MDI). Of 291 subjects, FEV 1 increased in 73 (25%) after bronchodilator ! À 12% compared to baseline; the number of subjects with a ! 35% increase in MEF 50 or FEF 25 -75 were similar in terms of percentage (respectively, 29.2% and 29%), whereas those with increases in FVC (! 12%) and in PEF (! 15%) were significantly lower (respectively, 2.7% and 12.3%). The percentage of subjects with RAO (FEV 1 increase after bronchodilator ! 12%) was lower (12%) in the subgroup (108 subjects), with an MEF 50 ! 70% of the value predicted at the baseline assessment, and higher (36%) in the subjects of the subgroup (183 subjects) with an MEF 50 < 70%. In conclusion, it is advisable to carry out reversibility tests in all subjects with symptoms indicative of asthma even if their functional tests are ''normal'' because in a considerable number of cases the RAO was found to confirm the suspected diagnosis and provided a more reliable classification of the disease.

The Prevalence of Atopy and Asthma among University Freshmen in Seoul, Korea: Association with Obesity

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The Response to Bronchodilators in Adults is not Predictive of Bronchial-hyperreactivity

“…The prevalence of the response to broncho-dilating agents was significantly higher among subjects with lower baseline FEV 1 values, representing accentuation of increased bronchial tone or mild airway obstruction. Similarly, Mariotta et al (12) have suggested to perform reversibility tests in all subjects with symptoms indicative of asthma even if their spirometry is "normal" because in a considerable number of cases reversibility confirmed the diagnosis. A similar report by Yurdakul demonstrated high correlation between the results of the reversibility and the presence asthma (13).…”