The Value of Fractional Exhaled Nitric Oxide and Impulse Oscillometric and Spirometric Parameters for Predicting Bronchial Hyperresponsiveness in Adults with Chronic Cough
| Autor: | Mei Zi, Dongzhu Lu, Hua-Peng Yu, Ling-Ling Wu, Li-Chang Chen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty resonant frequency diagnosis Logistic regression maximum mid-expiratory flow Internal medicine Journal of Asthma and Allergy medicine Immunology and Allergy cough variant asthma Internal validation Original Research Receiver operating characteristic business.industry respiratory system medicine.disease Predictive value ROC curve respiratory tract diseases Chronic cough Impulse Oscillometry Bronchial hyperresponsiveness Exhaled nitric oxide Cardiology medicine.symptom business |
| Zdroj: | Journal of Asthma and Allergy |
| ISSN: | 1178-6965 |
| Popis: | Lichang Chen,1,* Lingling Wu,1,* Dongzhu Lu,1 Mei Zi,2 Huapeng Yu1 1Department of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Peopleâs Republic of China; 2Department of Respiratory and Critical Care Medicine, The Third Peopleâs Hospital of Shenzhen, Shenzhen, Peopleâs Republic of China*These authors contributed equally to this workCorrespondence: Huapeng YuDepartment of Respiratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510220, Peopleâs Republic of ChinaTel +86 020 61643175Fax +86 020 84306143Email huapengyu@aliyun.comPurpose: To evaluate the contribution of fractional exhaled nitric oxide (FeNO) and impulse oscillometry (IOS) and spirometric parameters in predicting bronchial hyperresponsiveness (BHR) in adults with chronic cough.Patients and Methods: In total, 112 patients with chronic cough were enrolled in this prospective diagnostic study. Receiver operating characteristic (ROC) curves were generated to assess the diagnostic efficiency and optimal cut-off values of FeNO and IOS and spirometric parameters in predicting BHR. Optimal combinations of FeNO and IOS and spirometric parameters for BHR prediction were investigated using univariate and multivariate logistic regression models. Bootstrapping was employed for internal validation. Model discrimination and calibration were assessed using indices and calibration plots.Results: Rhinitis and values of FeNO, IOS parameters (resonant frequency (Fres), reactance at 5 Hz (X5), and integrated area of low-frequency X (AX)) and spirometric parameters (FEV1, PEF, MEF75, MEF50, MEF25, MMEF) were significantly different between patients with BHR and those without BHR (P < 0.05). After adjusting for rhinitis, logistic analyses showed that FeNO combined with Fres, FeNO combined with MMEF, or the combination of FeNO, Fres and MMEF had high predictive value in diagnosing BHR; the areas under the ROC curves (AUCs) of the corresponding three models were 0.914, 0.919 and 0.927, respectively. In addition, the three models displayed good discrimination, with high C-index values and good calibration.Conclusion: FeNO combined with Fres or MMEF or a combination of these three parameters may be conveniently used as indicators in BHR prediction.Keywords: maximum mid-expiratory flow, resonant frequency, cough variant asthma, ROC curve, diagnosis |
| Databáze: | OpenAIRE |
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