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(FEV3-FEV1)/FVC: A Terminal-Airflow Variable for Airway Hyperresponsiveness and Inflammation Prediction in Patients
Wuping Bao1, Yanmei Lin1, Lei Zhao1
1Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
The Journal of Allergy and Clinical Immunology. in Practice
|October 18, 2024
Summary
The ratio of forced expiratory volume in 3 seconds to forced vital capacity ((FEV3-FEV1)/FVC) effectively identifies airway hyperresponsiveness (AHR) and inflammation in asthma patients with normal spirometry. This marker aids in monitoring individuals at risk for uncontrolled asthma.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
- Asthma Research
Background:
- Assessing small-airway function is critical for diagnosing and managing asthma.
- Abnormalities in terminal airflow are significant indicators in respiratory health.
Purpose of the Study:
- To determine if the (FEV3-FEV1)/FVC ratio correlates with airway hyperresponsiveness (AHR) and inflammation in patients with preserved spirometry.
- To evaluate the utility of (FEV3-FEV1)/FVC as a marker for AHR and airway inflammation in asthma.
Main Methods:
- Cross-sectional study of 553 patients with preserved spirometry (FEV1 ≥ 80%, FEV1/FVC ≥ 0.7) and asthma-like symptoms.
- Collected data on demographics, FeNO, impulse oscillometry, and spirometry.
- Analyzed univariate and combined models for AHR prediction and validated findings in 561 patients.
Main Results:
- Patients with AHR showed significantly higher (FEV3-FEV1)/FVC ratios.
- The ratio strongly correlated with methacholine dose causing a 20% FEV1 decrease (r = 0.39) and response dose ratio (r = -0.26).
- (FEV3-FEV1)/FVC outperformed other spirometric measures in identifying eosinophilic airway inflammation and correlated with sputum eosinophil counts.
Conclusions:
- Elevated (FEV3-FEV1)/FVC levels are indicative of AHR and airway inflammation in patients with seemingly normal spirometry.
- This ratio serves as a sensitive marker for AHR and inflammation, correlating with key clinical measures.
- The findings suggest (FEV3-FEV1)/FVC is valuable for monitoring patients at risk of uncontrolled asthma.
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