Xiaoli Sun1, Wenlan Yang2, Sugang Gong3, Shuo Liang1, Shuyi Gu1, Haiwen Lu1, Jinmin Liu3, Jinfu Xu1. 1. Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital Tongji University School of Medicine, Shanghai 200433, China. 2. Department of Pulmonary Function Test, Shanghai Pulmonary Hospital Tongji University School of Medicine, Shanghai 200433, China. 3. Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital Tongji University School of Medicine, Shanghai 200433, China.
Abstract
OBJECTIVES: To evaluate the quantitative changes and diagnostic performance of volumetric capnography (VCap) parameters in patients with cough variant asthma. METHODS: This cross-sectional study enrolled 31 patients with cough variant asthma and 30 patients with chronic cough without asthma between November 2010 and March 2012. VCap measurements were recorded at baseline, during the five steps of the histamine challenge, and after bronchodilation with salbutamol. They were then compared between the baseline and histamine challenge, and between the two groups. Receiver operating characteristic curve analysis was performed for different VCap measurements. RESULTS: The slope of phase III (dc\dv3) and the ratio of phase III slope to phase II slope (SR23%) decreased from baseline upon challenge with 1.1 mg histamine in cough variant asthma patients but increased in patients with chronic cough without asthma. Additionally, the change upon challenge with 1.1 mg histamine in dc\dv3 from baseline (S6-S1dc\dv3) in cough variant asthma patients had the largest area under the curve (AUC) (0.814, 95% CI: 0.697-0.931; p<0.001). The AUC for change upon challenge with 1.1 mg histamine in SR23% from baseline was 0.755 (95%CI: 0.632-0.878; p<0.001). At a cutoff of 19.8, S6-S1 dc\dv3 had a sensitivity of 74.2% and specificity of 90.0% and at a cutoff of 40.7, S6-S1 SR23% had a sensitivity of 48.4% and specificity of 96.7%. CONCLUSION: Patients with cough variant asthma exhibit distinct VCap responses for dead space parameters upon challenge with histamine in comparison to patients with chronic cough. VCap parameters like phase III slope and phase III/phase II slope ratio could be used to aid the diagnosis of cough variant asthma.
OBJECTIVES: To evaluate the quantitative changes and diagnostic performance of volumetric capnography (VCap) parameters in patients with cough variant asthma. METHODS: This cross-sectional study enrolled 31 patients with cough variant asthma and 30 patients with chronic cough without asthma between November 2010 and March 2012. VCap measurements were recorded at baseline, during the five steps of the histamine challenge, and after bronchodilation with salbutamol. They were then compared between the baseline and histamine challenge, and between the two groups. Receiver operating characteristic curve analysis was performed for different VCap measurements. RESULTS: The slope of phase III (dc\dv3) and the ratio of phase III slope to phase II slope (SR23%) decreased from baseline upon challenge with 1.1 mg histamine in cough variant asthma patients but increased in patients with chronic cough without asthma. Additionally, the change upon challenge with 1.1 mg histamine in dc\dv3 from baseline (S6-S1dc\dv3) in cough variant asthma patients had the largest area under the curve (AUC) (0.814, 95% CI: 0.697-0.931; p<0.001). The AUC for change upon challenge with 1.1 mg histamine in SR23% from baseline was 0.755 (95%CI: 0.632-0.878; p<0.001). At a cutoff of 19.8, S6-S1 dc\dv3 had a sensitivity of 74.2% and specificity of 90.0% and at a cutoff of 40.7, S6-S1 SR23% had a sensitivity of 48.4% and specificity of 96.7%. CONCLUSION: Patients with cough variant asthma exhibit distinct VCap responses for dead space parameters upon challenge with histamine in comparison to patients with chronic cough. VCap parameters like phase III slope and phase III/phase II slope ratio could be used to aid the diagnosis of cough variant asthma.
Authors: Abubakar Abid; Rebecca J Mieloszyk; George C Verghese; Baruch S Krauss; Thomas Heldt Journal: IEEE Trans Biomed Eng Date: 2017-05-02 Impact factor: 4.538
Authors: Teresa To; Sanja Stanojevic; Ginette Moores; Andrea S Gershon; Eric D Bateman; Alvaro A Cruz; Louis-Philippe Boulet Journal: BMC Public Health Date: 2012-03-19 Impact factor: 3.295