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Kim, Lee, Lee, Cho, Na, and Han: The Complementary Role of FEV6 in Bronchodilator Reversibility Test for the Old Age
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 61(3): 227-232.

Published online: 30 September 2006

DOI: https://doi.org/10.4046/trd.2006.61.3.227

The Complementary Role of FEV6 in Bronchodilator Reversibility Test for the Old Age

Sae Hee Kim, M.D., Yang Deok Lee, M.D., Jung Yun Lee, M.D., Yong Seon Cho, M.D., Dong Jip Na, M.D., Min Soo Han, M.D.

Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.

Address for correspondence: Yang Deok Lee, M.D. Department of Internal Medicine, Eulji University Hospital, 1306 Doonsan-Dong, Seo-Gu, Daejeon, Korea, 302-799. Phone: 82-42-611-3154, Fax: 82-42-259-1111, lydmd@hanmail.net

Received 19 July 2006       Accepted 7 September 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

In the measurement of bronchodilator reversibility, the forced expiratory volume in one second(FEV1) and the forced vital capacity(FVC) are commonly used parameters and recommended criteria for the reversibility requiring an increase of more than 200ml and 12% above the baseline, respectively. However, aged patients do not often meet the criteria of an increase in volume(>200ml) even though the medical history of that patient is adequate for asthma. This study investigated the role of the forced expiratory volume in six seconds(FEV6) in the bronchodilator reversibility test in elderly patients.

Methods

A total of 236 patients more than 65 years of age with a FEV1/FVC ratio<80% were enrolled in this study. The bronchodilator revesibility tests were examined. With the setting FEV1 as the baseline, the patients were divided into three groups;
Group I : FEV1≧80% of the predicted value,
Group II : 60%<FEV1<80% of the predicted value,
Group III : FEV1≦60% of the predicted value.

Results

Positive reversibility in the FEV1, FEV6, and FVC was in 33(14.0%), 49(20.8%) and 55(23.3%). However, Group III presented with reversibility in the FEV1, FEV6, and FVC in 15(22.4%), 30(44.8%) and 32(47.8%) respectively.

Conclusions

The FEV6 might be used as a complementary parameter in bronchodilatror reversibility in elderly patients. However, more study will be needed to determine the usefulness of FEV6 in bronchodilator reversibility test.

Keywords: FEV6, Bronchodilator reversibility test, The old age

Figures and Tables

Figure 1
Positive reversibility according to the different parameters for each groups of 236 patients
trd-61-227-g001
Table 1
Demographics and clinical characteristics of patients
trd-61-227-i001

Values are mean±standard deviation.

*forced vital capacity, †forced expiratory volume in one second, ‡forced expiratory volume in six seconds, §body mass index, ∥changes after bronchodilator reversibility test

Table 2
Clinical characteristics of each groups, subdivided into three groups according to FEV1
trd-61-227-i002

Values are mean±standard deviation.

*forced vital capacity, †forced expiratory volume in one second, ‡forced expiratory volume in six seconds, §body mass index, ∥changes after bronchodilator reversibility test

Table 3
Bronchodilator reversibility in FEV6 and commonly used parameters
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Values are number of patients.

*bronchodilator reversibility using FVC and/or FEV1 as parameters,

†bronchodilator reversibility using only FEV6 as parameter

The BDR as the gold standard, the measured sensitivity, specificity, positive predictive value, and negative predictive value of FEV6 in reversibility test are 64.3%, 100%, 100%, 95.4% in group I, 50.0%, 97.3%, 83.3%, 87.8% in group II, 38.9%, 86.7%, 63.6%, 70.3% in group III, 50.0%, 97.1%, 80.8%, 88.8% in total, respectively.

Table 4
Bronchodilator reversibility according to the each parameters
trd-61-227-i004

Values are number of patients.

*bronchodilator reversibility using only FVC as parameter, †bronchodilator reversibility using only FEV1 as parameter, ‡bronchodilator reversibility only FEV6 as parameter

The reversibility of FVC as the gold standard, the measured sensitivity, specificity, positive predictive value, and negative predictive value of FEV6 in reversibility test are 75%, 100%, 100%, 97.2% in group I, 72.7%, 95%, 80%, 92.7% in group II, 72.7%, 82.4%, 80%, 75.7% in group III, 63.4%, 95.6%, 76.5%, 93.6% in total, respectively.

The reversibility of FEV1 as the gold standard, the measured sensitivity, specificity, positive predictive value, and negative predictive value of FEV6 in reversibility test are 77.8%, 98.2%, 77.8%, 98.2% in group I, 66.7%, 90.5%, 60%, 92.7% in group II, 71.4%, 62.3%, 33.3%, 89.2% in group III, 71.9%, 87.3%, 47.0%, 95.2% in total, respectively.

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