Area Under the Expiratory Flow-Volume Curve (AEX): Assessing Bronchodilator Responsiveness. 2020

Octavian C Ioachimescu, and James K Stoller
Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, School of Medicine, Emory University, Atlanta VA Sleep Medicine Center, 250 N Arcadia Ave, Decatur, GA, 30030, USA. oioac@yahoo.com.

Area under expiratory flow-volume curve (AEX) is a useful spirometric tool in stratifying respiratory impairment. The AEX approximations based on isovolumic flows can be used with reasonable accuracy when AEX is unavailable. We assessed here pre- to post-bronchodilator (BD) variability of AEX4 as a functional assessment tool for lung disorders. The BD response was assessed in 4330 subjects by changes in FEV1, FVC, and AEX4, which were derived from FVC, peak expiratory flow, and forced expiratory flow at 25%, 50%, and 75% FVC. Newly proposed BD response categories (negative, minimal, mild, moderate and marked) have been investigated in addition to standard criteria. Using standard BD criteria, 24% of subjects had a positive response. Using the new BD response categories, only 23% of subjects had a negative response; 45% minimal, 18% mild, 9% moderate, and 5% had a marked BD response. Mean percent change of the square root AEX4 was 0.3% and 14.3% in the standard BD-negative and BD-positive response groups, respectively. In the new BD response categories of negative, minimal, mild, moderate, and marked, mean percent change of square root AEX4 was - 8.2%, 2.9%, 9.2%, 15.0%, and 24.8%, respectively. Mean pre- to post-BD variability of AEX4 was < 6% and stratified well between newly proposed categories of BD response (negative, minimal, mild, moderate and marked). We suggest that AEX4 (AEX) could become a useful measurement for stratifying dysfunction in obstructive lung disease and invite further investigation into indications for using bronchodilator agents or disease-modifying, anti-inflammatory therapies.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001993 Bronchodilator Agents Agents that cause an increase in the expansion of a bronchus or bronchial tubes. Bronchial-Dilating Agents,Bronchodilator,Bronchodilator Agent,Broncholytic Agent,Bronchodilator Effect,Bronchodilator Effects,Bronchodilators,Broncholytic Agents,Broncholytic Effect,Broncholytic Effects,Agent, Bronchodilator,Agent, Broncholytic,Agents, Bronchial-Dilating,Agents, Bronchodilator,Agents, Broncholytic,Bronchial Dilating Agents,Effect, Bronchodilator,Effect, Broncholytic,Effects, Bronchodilator,Effects, Broncholytic
D005260 Female Females
D005541 Forced Expiratory Volume Measure of the maximum amount of air that can be expelled in a given number of seconds during a FORCED VITAL CAPACITY determination . It is usually given as FEV followed by a subscript indicating the number of seconds over which the measurement is made, although it is sometimes given as a percentage of forced vital capacity. Forced Vital Capacity, Timed,Timed Vital Capacity,Vital Capacity, Timed,FEVt,Capacities, Timed Vital,Capacity, Timed Vital,Expiratory Volume, Forced,Expiratory Volumes, Forced,Forced Expiratory Volumes,Timed Vital Capacities,Vital Capacities, Timed,Volume, Forced Expiratory,Volumes, Forced Expiratory
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D013147 Spirometry Measurement of volume of air inhaled or exhaled by the lung. Spirometries
D014797 Vital Capacity The volume of air that is exhaled by a maximal expiration following a maximal inspiration. Forced Vital Capacity,Capacities, Forced Vital,Capacities, Vital,Capacity, Forced Vital,Capacity, Vital,Forced Vital Capacities,Vital Capacities,Vital Capacities, Forced,Vital Capacity, Forced

Related Publications

Octavian C Ioachimescu, and James K Stoller
April 2015, Pneumologie (Stuttgart, Germany),
Octavian C Ioachimescu, and James K Stoller
September 2003, Pediatric pulmonology,
Octavian C Ioachimescu, and James K Stoller
March 2009, Primary care respiratory journal : journal of the General Practice Airways Group,
Octavian C Ioachimescu, and James K Stoller
September 1979, Medical & biological engineering & computing,
Octavian C Ioachimescu, and James K Stoller
January 1979, Respiration; international review of thoracic diseases,
Octavian C Ioachimescu, and James K Stoller
January 1972, Plucne bolesti i tuberkuloza,
Octavian C Ioachimescu, and James K Stoller
January 1981, Indian journal of physiology and pharmacology,
Octavian C Ioachimescu, and James K Stoller
January 1975, Le Poumon et le coeur,
Octavian C Ioachimescu, and James K Stoller
January 2008, Respiration; international review of thoracic diseases,
Copied contents to your clipboard!