Methacholine Challenge Testing: Comparison of FEV<sub>1</sub> and Airway Resistance Parameters

Urbankowski, Tomasz; Przybyłowski, Tadeusz

doi:10.4187/respcare.08331

Cited by 5 publications

(7 citation statements)

References 42 publications

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“…The MCT has traditionally been interpreted based on changes in FEV 1 , however multiple studies, including ours, have recognized that other significant changes in lung function occur 6–14 . Methacholine is expected to result in airway narrowing and mucus hyper‐secretion through acetylcholine agonism and thus a drop in FEV 1 23 .…”

Section: Discussionmentioning

confidence: 91%

“…However, we tried to validate the clinical diagnosis based on the prescription of medications related to asthma in the year following the MCT (see Table S1 in the Supporting Information). Third, we chose a cut‐off for sGaw at PC 40 , but other cut‐offs have been suggested 6,8,9,12–14,30,31 . While these different cut‐offs would change the results slightly, we do not think they would change the main finding of the study.…”

Section: Discussionmentioning

confidence: 99%

“…Our results extend these findings by demonstrating the clinical relevance related to asthma of methacholine responsiveness defined by PC 40 for sGaw. Other studies have examined the response of sGaw to methacholine, but they were done to validate sGaw in comparison to FEV 1 in patients with known asthma [8][9][10]14 rather than to examine the diagnostic utility of sGaw for asthma.…”

Section: Discussionmentioning

confidence: 99%

“…1 However, other physiological responses to methacholine also occur, such as an increase in airway resistance and hyperinflation of lung volumes. [2][3][4][5] In particular, a fall in specific airway conductance (sGaw) may be useful since it takes into account any change in lung volume [6][7][8][9][10][11][12][13][14] and may yield additional information beyond change in FEV 1 . 15 We hypothesize that changes in sGaw in response to methacholine challenge reflect clinically significant AHR.…”

Section: Introductionmentioning

confidence: 99%

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Validation of the clinical utility of sGaw as a response variable in methacholine challenge testing

et al. 2022

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Background and Objective Airway hyperresponsiveness (AHR) is commonly assessed by a methacholine challenge test (MCT), during which a provocative concentration causing a 20% reduction in forced expiratory volume in 1 second (FEV1) (PC20) < 8 mg/ml is considered a positive response. However, a fall in specific airway conductance (sGaw) may also have clinical significance. The purpose of this study was to assess whether AHR determined by a provocative concentration causing a 40% reduction in sGaw (PC40) < 8 mg/ml corresponds to a clinical diagnosis of asthma. Methods We analysed the changes in spirometry, lung volumes and sGaw during MCT in 211 randomly selected patients being evaluated for AHR to support a clinical diagnosis of asthma. Results The mean (SD) age of the group was 53 (15) years, with 141 women (67%). Overall lung function was normal, with FEV1 = 92 (15) % predicted, total lung capacity = 97 (13) % predicted and sGaw = 0.19 (0.15–0.23) L/s/cm H2O/L, (median, 25–75 IQR). There were many more patients who responded by PC40 only (n = 120) than who responded by PC20 (n = 52). There was no significant difference in asthma diagnosis between the PC20 (98%) and PC40 (93%) groups, and we estimate 34% of patients with a diagnosis of asthma would have been classified as having no AHR if only the FEV1 criterion was used. Conclusion Changes in sGaw during MCT indicate clinically significant AHR in support of a clinical diagnosis of asthma among patients being evaluated for asthma.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Validation of the clinical utility of sGaw as a response variable in methacholine challenge testing

et al. 2022

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“…Compared to acetylcholine, it is hydrolyzed more slowly by acetylcholinesterase. Due to its resistance to nonspecific cholinesterase, methacholine's effect is longer but can be reduced or eliminated with atropine or other similar anticholinergics (21). The negative predictive value of the methacholine test is above 90%, while its positive predictive value is less than one at a concentration of 90% and is about 70% at a concentration (22).…”

Section: Key Pointmentioning

confidence: 99%

Evaluation of methacholine challenge test results in patients with chronic unexplained cough

2022

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Introduction: Asthma is one of the most common chronic diseases in adults characterized by variable airway obstruction. Asthma is diagnosed with wheezing and shortness of breath, however it sometimes manifests as a chronic cough that is difficult to diagnose and requires spirometry stimulation tests. Objectives: This study aimed to investigate the relationship between methacholine test results and respiratory symptoms in patients with chronic unexplained cough. Patients and Methods: In this cross-sectional study, 102 patients with chronic cough and normal basal spirometry were included. All patients underwent a methacholine challenge test, and their airway irritabilities were assessed. Then, the relationship between methacholine test results and clinical symptoms and also demographic characteristics were investigated. Results: Of 102 patients, 69 (67.6 %) and 33 (32.4%) were female and male, respectively. Most of patients were non-smoker (90.2%). Around 25 (24.5%) patients had a positive methacholine test. Rhinitis had a statistically significant difference between patients with positive and negative tests (positive test group: 48%, negative test group: 23.4%; P = 0.01). Postnasal discharge was reported in 60% of positive methacholine test patients, which was significant compared to the negative group (36.4%; P = 0.03). Most patients who had positive tests were housewives (76%). Logistic regression showed that female gender (OR: 7.75, 95% CI: 1.7-35.2), postnasal discharge (OR: 3.19, 95% CI: 1.25-8.2), rhinitis (OR: 3.02, 95% CI: 1.17-7.79), and allergy symptoms OR: 3.51, 95% CI: 1.35-9.18) were directly associated with a positive methacholine test. Conclusion: The presence of airway hypersensitivity, postnasal discharge, allergic rhinitis, female gender and the housewife’s job were strongly associated with a positive methacholine test.

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A new tidal breathing measurement device detects bronchial obstruction during methacholine challenge test

Zachariades,

Bachar,

Danino

et al. 2024

Advances in Medical Sciences

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Methacholine Challenge Testing: Comparison of FEV₁ and Airway Resistance Parameters

Cited by 5 publications

References 42 publications

Validation of the clinical utility of sGaw as a response variable in methacholine challenge testing

Validation of the clinical utility of sGaw as a response variable in methacholine challenge testing

Evaluation of methacholine challenge test results in patients with chronic unexplained cough

A new tidal breathing measurement device detects bronchial obstruction during methacholine challenge test

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Methacholine Challenge Testing: Comparison of FEV1 and Airway Resistance Parameters

Cited by 5 publications

References 42 publications

Validation of the clinical utility of sGaw as a response variable in methacholine challenge testing

Validation of the clinical utility of sGaw as a response variable in methacholine challenge testing

Evaluation of methacholine challenge test results in patients with chronic unexplained cough

A new tidal breathing measurement device detects bronchial obstruction during methacholine challenge test

Contact Info

Product

Resources

About

Methacholine Challenge Testing: Comparison of FEV₁ and Airway Resistance Parameters