Pediatr Allergy Respir Dis.  2012 Jun;22(2):171-179.

Usefulness of DeltaFEV0.75 and DeltaFEV0.5 for Airway Reversibility in Preschoolers with Asthma

• Park HB
• Kim YH
• Baek JY
• Kim KW
• Sohn MH
• Kim KE

Abstract

PURPOSE
Preschoolers complete forced expiration in a short time, sometimes more quickly than in 1 second, and therefore the importance of forced expiatory volume in 0.75 seconds (FEV0.75) or forced expiatory volume in 0.5 seconds (FEV0.5) has been raised. The purpose of this study is to evaluate the clinical usefulness of DeltaFEV0.75 and DeltaFEV0.5.
METHODS
We analyzed 401 subjects of an asthma group, and 150 subjects of a control group under 7 years of age.
RESULTS
DeltaFEV1, DeltaFEV0.75 and DeltaFEV0.5 values of the asthma group were significantly higher than those of the control group, respectively (P<0.0001). DeltaFEV1 (0.60; 95% confidence interval [CI], 0.57 to 0.62), DeltaFEV0.75 (0.61; 0.58 to 0.65), and DeltaFEV0.5 (0.60; 0.56 to 0.64) showed no significant difference in the diagnostic ability of asthma when airway reversibility is defined as DeltaFEVt> or =12%. Cutoff values for asthma were 8.6% in DeltaFEV1, 7.9% in DeltaFEV0.75 and 14.2% in DeltaFEV0.5. DeltaFEV0.75 (0.91; 0.88 to 0.94) showed significantly higher area under curve (AUC) than DeltaFEV0.5 (0.77; 0.73 to 0.82) when stratified by 12%, in predicting airway reversibility defined as DeltaFEV1> or =12%. Cutoff values were 12.3% in DeltaFEV0.75, and 13.4% in DeltaFEV0.5. When airway reversibility is defined as DeltaFEV1> or =8.6%, DeltaFEV0.75 (0.90; 0.87 to 0.92) also showed significantly higher AUC than DeltaFEV0.5 (0.79; 0.75 to 0.82), and Cutoff values were 8.4% in DeltaFEV0.75, and 11.3% in DeltaFEV0.5.
CONCLUSION
DeltaFEV0.75 or DeltaFEV0.5 can be a means to replace DeltaFEV1 for diagnosis of asthma and assessment of airway reversibility in preschool children.

Keyword

Spirometry; Preschool children; Asthma; Forced expiratory volume

MeSH Terms

Area Under Curve
Asthma
Child, Preschool
Forced Expiratory Volume
Humans
Spirometry

Figure

• 

  Fig. 1 Receiver operating characteristic (ROC) curves of ΔFEV1, ΔFEV0.75 and ΔFEV0.5 for diagnosis of asthma when bronchodilator response is defined as ΔFEVt≥12%. ΔFEV1 (0.60; 95% confidence interval, 0.57-0.62), ΔFEV0.75 (0.61, 0.58-0.65), and ΔFEV0.5 (0.60, 0.56-0.64) showed no significant difference in area under curve of ROC curves. FEV1, forced expiratory volume in 1 second; FEV0.75, forced expiratory volume in 0.75 second; FEV0.5, forced expiratory volume in 0.5 second.

• 

  Fig. 2 Receiver operating characteristic (ROC) curves ΔFEV0.75 and ΔFEV0.5 when stratified by 12% for airway reversibility defined as ΔFEV1≥12%. ΔFEV0.75 (0.91, 0.88-0.94) showed significantly higher area under curve than ΔFEV0.5 (0.77, 0.73-0.82). FEV0.75, forced expiratory volume in 0.75 second; FEV0.5, forced expiratory volume in 0.5 second.

• 

  Fig. 3 Receiver operating characteristic (ROC) curves ΔFEV0.75 and ΔFEV0.5 when stratified by 8.6% for airway reversibility defined as ΔFEV1≥8.6%. ΔFEV0.75 (0.90, 0.87-0.92) showed significantly higher area under curve than ΔFEV0.5 (0.79, 0.75-0.82). FEV0.75, forced expiratory volume in 0.75 second; FEV0.5, forced expiratory volume in 0.5 second.

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