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PubMed1993

[Relationship between smoking habits and lung function changes with conventional spirometry].

Maximal expiratory flow and volume parameters derived from simultaneous maximal expiratory flow-volume and volume-time curves obtained by the forced vital capacity maneuver were studied in 311 healthy normal Chinese men, consisting of 180 nonsmokers and 131 smokers of 20 to 78 years of age. Six maximal expiratory parameters--FVC, FEV1, FEV1/FVC, PEFR, FEF25-75% and Vmax75, both unadjusted and adjusted for age and body height, were compared between nonsmokers and smokers to study the effects of smoking on ventilatory function and to detect early abnormal changes. In current smokers and ex-smokers, the FEV1/FVC was significantly lower than that of nonsmokers. However, no such differences were noted for FVC and FEV1. Among FVC, FEV1 and FEV1/FVC, a low FEV1/FVC appeared to be the earliest discriminative index in normal asymptomatic smokers. With increasing quantity and duration of smoking, a higher incidence of abnormally low FEV1 and FVC compared to those who smoked a lesser amount or for a shorter period of time, were observed in sequence. Current smokers over the first 5 pack-yrs of smoking did not show any abnormality in FVC, FEV1 and FEV1/FVC. It is concluded that cigarette smoking is associated with a decrease in pulmonary function although the effects take some time to develop and are not immediately apparent after beginning the smoking habit. There is an irreversible decrease in FEV1/FVC with cumulative cigarette consumption, but smoking cessation will prevent further deterioration in FEV1 and FVC.

Adult↗
PubMed1994

[Exercise tests in spirometry].

Actual situation: There is a great variety of exercise programs (formerly called protocols) used in daily routine and general practice. Exercise programs vary with increments, step-duration, speed and grade, although standard recommendations have been published recently. In the USA, the Bruce program is widely accepted, although some criticism has been published. Comparing different exercise programs it is obvious, that maximal values (VO2, heart rate etc.) are only moderately affected by the program, but submaximal values are strongly influenced by the methodological procedure. Advantages and disadvantages of the different exercise testing procedures will be presented. As we need some standardized exercise programs to avoid "free-style ergometry", recommendations may be based on the following assumptions: Exercise testing should not be too short nor too long (10-12 min total test time), work rate increments should be intermediate (adapted to physical fitness), work rate steps should be about 2 min or an individualized ramp test should be used. Exercise test programs have to be selected according to the patient's fitness, to the disease or function to be studied, and to the laboratory setting. Standardization is strongly recommended.

Exercise Test↗
PubMed1993

[Use of spirometry in the evaluation of the cardiovascular and respiratory system in mitral valve prosthesis].

Before the operation, in 103 patients with the defects of the right and left atrioventricular valves, echocardiography and spiro-ergometry were performed. Their performance permitted to reveal latent myocardial incompetence in these patients. Changes in the indices of external respiration and gas exchange at a level of the threshold standard load can serve as objective criteria for assessment of reserve resources of the cardiovascular and respiratory systems and prognosis of the development of acute cardiac failure at the shortest period after the mitral valve replacement.

Adolescent↗
PubMed1993

[Chronotropic and pressoric response in myocardiopathy in patients with heart failure during ergometric test. Correlation of spirometry variables with effort].

PURPOSE: To correlate the variables heart rate (HR), blood pressure (BP) and double product (DP) during the ergometric test with the variables oxygen consumption (VO2) and pulmonary ventilation (VE) of spiroergometry. METHODS: A study was carried out with 40 male patients suffering from cardiomyopathy with heart failure (functional class II-IV of NYHA)-of ischemic (IS), Chagas' disease (CH) and idiopathic (ID) etiology. These three groups were compared to a group of 10 normal individuals (N). The 4 groups were evaluated under 4 different conditions: rest (RES), anaerobic threshold (LA), power peak of exercise (P) and in the fourth minute recovery (REC). The investigation was carried out with the data obtained through spiroergometry (using a treadmill and spiroergometric equipment specific for the effort), as well as data related to HR, BP, DP, VO2 and VE. RESULTS: There were significant differences observed in the ergometric evaluate of the HR, BP and DP responses in the IS, CH and ID groups as compared with the N group. There were significant difference observed in the spirometric evaluation to the VO2 and VE efforts in the IS, CH and ID groups as compared with the N group. CONCLUSION: The HR, BP and DP variables studies, obtained by means of classic ergometry, unaided by direct methodology (spiroergometry) enabled them to infer valuable data for the control and evaluation of cardiomyopathies with IC, taking into consideration the low chronotropic and pressoric responses in the various phases of evaluation during this study, corresponding to the concomitant low performance of O2 consumption and pulmonary ventilation.

Adult↗
PubMed1993

An easy method of spirometry.

Recording of forced expiration from tidal inspiratory level-referred to as Forced Expiratory Capacity (FEC) is a simple and more convenient technique than the conventional forced vital capacity (FVC) manouvre. From FEC tracing, volume expelled in one second (FEC1) and its percentage (FEC1%) can be measured. Such spirometric recording obtained from tidal breathing to Residual Volume (RV) may be referred to as Spirometric Recording at low lung volume. Asthmatics as well as old subjects find this manouvre easier to perform than the conventional FVC technique. FEC recording becomes a simple, reliable and sensitive test for evaluation of early airway obstruction in asymptomatic smokers and therefore may be utilised in clinical and epidemiologic surveys.

Adolescent↗
PubMed1993

Dose-response study of inhaled salmeterol in asthmatic patients with 24-hour spirometry and Holter monitoring.

Salmeterol is a new long-acting beta 2-selective adrenoceptor agonist. In this double-blind, 6-way crossover study, four single doses of salmeterol by metered dose inhaler (12.5, 25, 50, 100 micrograms) were compared with albuterol aerosol 200 micrograms and placebo in 24 patients with moderate asthma with 24-hour pulmonary function testing and Holter monitoring. Salmeterol was an effective bronchodilator at each dose evaluated and demonstrated a greater increase in FEV1 above baseline, a slightly slower onset and a longer duration of bronchodilation than albuterol. Median durations of bronchodilation were 9.0, 15.6, 13.4, and 18.4 hours with increasing doses of salmeterol in comparison to 4.2 hours for albuterol. Holter monitoring showed (1) a mean maximum heart rate 2 to 5 bpm higher after salmeterol 50 and 100 micrograms compared with placebo and (2) supraventricular premature beats (> 30 per hour or > 100 per 24 hours) more often in the salmeterol 100-micrograms group (13% to 17% of patients) than in the placebo (4%), albuterol (4% to 8%), or other salmeterol groups (4% to 9%). These differences were not statistically significant. Tremor and palpitations were the most frequently reported drug-related adverse events and their frequencies increased with increasing doses of salmeterol. This study demonstrated that single doses of salmeterol given by metered dose inhaler over an 8-fold range possess substantial, long-lasting bronchodilator activity.

Administration, Inhalation↗
PubMed1977

Ability of spirometry, flow-volume curves and the nitrogen closing volume test to detect smokers. A population study.

Vital capacity, FEV1 and various measurements of forced expiratory flows as well as closing volume (CV), closing capacity (CC), the mean slope of the alveolar plateau (phase III), the maximal amplitude of the cardiogenic oscillations (N2-osc), and other variables obtained from the nitrogen CV-test were measured in random samples of 50- (n = 221) and 60-year-old (n - 410) men in Gothenburg. All the variables were significantly different in smokers consuming 15 g or more tobacco daily compared with asymptomatic non-smokers. Reference values were established from measurements in the non-smokers without respiratory symptoms, and the sensitivities of the measured variables to tobacco smoking were assessed. Phase III revealed the highest sensitivity, being abnormal in about 40-60 % of subjects smoking 15 g or more tobacco daily and in about 30-35 % of subjects smoking less. CV and FEV1 were approximately equally sensitive, being abnormal in about 10-30 % of subjects smoking 15 g or more daily and in about 5-20 % in subjects smoking less. Other measurements of maximal expiratory flow rates gave values below minus two standard deviations for the appropriate reference group in less than 15 % of the smokers. However, when we took the skewed distribution of reference values into account we found a two- to sixfold increase of the sensitivities of these variables in the 50-year-old smokers, in which abnormal values were obtained in about 30-40 % of subjects smoking 15 g or more daily and in about 10-15 % in subjects smoking less. Taking all variables obtained from the CV-test in conjunction, one or more abnormal valves were obtained in 60-70 % of the subjects smoking 15 g or more daily. To the extent that sensitivity to smoking reflects sensitivity to abnormalities in small airways, phase III appeared to be the most efficient single measurement for detection of this condition in the present age groups.

Cough↗
PubMed1996

[Agreement between reference values for spirometry recommended by the pneumology Spanish and European societies].

To determine whether spirometric reference values (RV) recommended by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) and the European Respiratory Society (ERS) are equivalent, and if the interpretation of these two RV leads to the same conclusions. A retrospective study of 3,690 spirometric readings (from 2,468 men and 1,222 women, ranging in age from 20 to 70 years old) of FVC, FEV1 and FEV1/FVC. Both quantitative (difference between RV obtained using the two sets of predictive equations) and qualitative (agreement of spirometric classifications using the two RV systems, by the method of standardized residuals, for FVC [non obstructive ventilatory defect] and FEV1/FVC [obstructive ventilatory defect], by calculating the kappa value). The difference in RV estimated by the two sets of equations is -0.544 l for FVC, -0.185 l for FEV1 and 2.36% for FEV1/FVC. In each case the agreement limits are not acceptable and bias is significant. Classifying patients by FVC, kappa was 50.03%. Classifying by FEV1/FVC, kappa was 93.66%. Bias is present for both parameters. The RV of SEPAR and ERS are not equivalent and this should be taken into consideration by manufacturers and distributors of equipment for lung function analysis. Each laboratory should be able to apply the RV most appropriate to the characteristics of the equipment used and the population studied.

Adult↗
PubMed1997

[Normal values for spirometry lung function values and peak flow for 7-18-year-old probands].

A prospective cohort study, designed to examine the long-term effects of air pollution on respiratory health, was conducted during the years 1977, 1979 and 1985 in Southwest Germany. In order to derive prediction equations, we analyzed the functional relationship of pulmonary function and anthropometric measures by graphical tools and regression analysis. Results are based on 10.605 spirometric measurements from 6625 individuals aged 7 to 18 years. Asthmatics, extremely overweighted persons, and smokers were excluded. Regression equations for the logarithmic transformation of FVC, FEV0.75 FEV1.0 MMEF and peak-flow are obtained separately for boys and girls, using the logarithms of standing height, weight and age as linear predictors. A comparison between equations from the present study and other available reference data shows that our prediction values for the volume parameters are at the upper end of the range given by other studies whereas for the flow parameters they lie in the middle of the range.

Adolescent↗