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KMID : 1035620210090030141
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Allergy Asthma & Respiratory Disease
2021 Volume.9 No. 3 p.141 ~ p.147
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Analysis of PC20-FEF25%?75% and ΔFVC in the methacholine bronchial provocation test
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Kim Hyeon-A
Kwon Jung-Eun
Ahn Ji-Young
Choe Jae-Young
Kim Dong-Sub
Park Sook-Hyun
Hyun Myung-Chul
Choi Bong-Seok
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Abstract
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Purpose: Forced expiratory flow between 25% and 75% (FEF25%?75%) is known to sensitively reflect bronchial obstruction. Methacholine challenge test (MCT) has shown varying reduction levels of forced vital capacity (FVC) with the reduction in forced expiratory volume in 1 second (FEV1) in asthma. The aim of this study was to evaluate the clinical implication of provocative concentration causing a 20% fall in FEF25%?75% (PC20-FEF25%?75%) and the percentage fall in FVC at the PC20 dose of methacholine (ΔFVC).
Methods: A total of 194 children who visited the hospital due to respiratory symptoms and underwent MCT were analyzed retrospectively. The patients were divided into 3 groups. Group I had both PC20-FEV1 and PC20-FEF25%?75% above 16 mg/mL; group II had a PC20-FEF25%?75% that fell below 16 mg/mL but PC20-FEV1 was 16 mg/mL or above; group III had a PC20-FEV1 and a PC20-FEF25%?75% that both fell below 16 mg/mL.
Results: In group II, PC20-FEV1 was lower (P=0.026) and the rate of change in FEV1 and FEF25%?75% from baseline to 16 mg/mL of methacholine concentration was greater than in group I (both P<0.001). Levels of PC20-FEF25%?75% were higher in group II compared to group III (P<0.001). ΔFVC showed a correlation with PC20-FEV1 (P<0.001) only in the whole group.
Conclusion: In asthmatic children, PC20-FEF25%?75% may be associated with bronchial hyperresponsiveness. ΔFVC was not associated with other parameters in either group. For subjects with a positive finding of PC20-FEF25%?75% and a negative finding of MCT, the progression to asthma can be suspected.
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KEYWORD
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Methacholine challenge test, Asthma, Child, Vital capacity, Forced expiratory flow
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