Clinical Physiology and Functional Imaging最新文献

{"title":"Assessing body composition through anthropometry: Implications for diagnosing and managing polycystic ovary syndrome (PCOS).","authors":"Suparna Parua, Arnab Das, Anukona Hazra, Prasenjit Chaudhuri, Koushik Bhattacharya, Sulagna Dutta, Pallav Sengupta","doi":"10.1111/cpf.12905","DOIUrl":"https://doi.org/10.1111/cpf.12905","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS) is a multifaceted endocrine disorder with profound implications for the reproductive and metabolic health of women. The utilization of anthropometric measures in the diagnosis and management of PCOS has gained increasing attention due to their practicality and predictive capacity for associated conditions such as obesity and insulin resistance. This review rigorously explores the application of various anthropometric indices, including body mass index, waist-to-hip ratio, and advanced metrics such as the body shape index and body roundness index, wrist circumference, neck circumference. These indices offer critical insights into body fat distribution and its association with the metabolic and hormonal perturbations characteristic of PCOS. The review underscores the necessity of addressing obesity, a prevalent comorbidity in PCOS, through lifestyle modifications and personalized therapeutic approaches. By incorporating anthropometric evaluations into routine clinical practice, healthcare professionals can enhance diagnostic precision, optimize treatment strategies, and ultimately improve patient outcomes. This integrative approach not only facilitates the management of the metabolic challenges inherent in PCOS but also contributes to the development of more individualized therapeutic interventions, thereby enhancing the overall quality of life for women affected by PCOS.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limb dominance does not have a meaningful impact on arterial occlusion pressure.","authors":"Yujiro Yamada, William B Hammert, Ryo Kataoka, Jun Seob Song, Anna Kang, Jeremy P Loenneke","doi":"10.1111/cpf.12906","DOIUrl":"https://doi.org/10.1111/cpf.12906","url":null,"abstract":"<p><strong>Introduction: </strong>Limb dominancy has been suggested, by some, to influence arterial occlusion pressure (AOP). However, we hypothesized that the differences in AOP between the dominant and nondominant legs were more likely explained by differences in cuff position.</p><p><strong>Aims: </strong>To determine the impact of limb dominance, composition, and cuff position on AOP in the context of error associated with measuring AOP twice on the same leg.</p><p><strong>Methods: </strong>Fifty-eight adults (30 males) volunteered to have AOP measured on their dominant legs with the cuff bladder covering their inner thighs and on their nondominant legs with the bladder covering their inner and outer thighs (in random order). Thigh circumference and muscle and fat thicknesses were also measured on each leg.</p><p><strong>Results: </strong>We found evidence for differences in AOP between legs [median δ of -0.222, 95% credible interval: (-0.429, -0.016)] when the cuff position was matched. The mean difference was -2.8 mmHg, and the 95% limit of agreement in a Bland-Altman plot was -24.8 to 19.0 mmHg. When plotting this alongside an error range (i.e., 95% limits of agreement) of taking the same measurement twice from our previous study (Spitz et al., 2020), 52 out of 58 measurements were within the error range. This difference was not due to the cuff position. Additionally, there was no evidence that thigh circumference or composition (muscle/fat thickness) moderated any difference between limbs.</p><p><strong>Conclusion: </strong>The difference in AOP between limbs is small and is mostly indistinguishable from the difference observed from taking the measurement twice on the same limb.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PET/MRI in paediatric inflammatory bowel disease - a prospective accuracy study.","authors":"Sina Dalby, Reza Piri, Ole Graumann, Oke Gerke, Thomas Lund Andersen, Anne-Mette Walsted, Kirsten Risby, Rasmus Gaardskær Nielsen, Anders Linnemann, Poul Flemming Høilund-Carlsen, Steffen Husby","doi":"10.1111/cpf.12903","DOIUrl":"https://doi.org/10.1111/cpf.12903","url":null,"abstract":"<p><p>Cross-sectional imaging supplements endoscopy in detecting disease manifestations in inflammatory bowel diseases (IBD). This study aimed to evaluate the accuracy of PET/MRI in a paediatric population suspected of IBD. This prospective study consecutively included patients aged 8-17 years under diagnostic evaluation for IBD. Forty-three patients underwent a PET/MRI scan and subsequent ileocolonoscopy, of whom 26 patients diagnosed with IBD participated in a follow-up scan, hereof 19 with Crohn's disease (CD), five with Ulcerative colitis and two with unclassified IBD. The results of PET alone, MRI alone, and PET/MRI combined were compared to a reference standard of endoscopy and histopathology. Of the 208 intestinal segments analysed, 109 showed inflammation, and 99 had no inflammation. In the per-segment analysis PET had a sensitivity of 0.83 (95% CI 0.73-0.93), specificity of 0.59 (95% CI 0.47-0.71), and area under the receiver operating characteristic curve (AUROC) of 0.73 (95% CI 0.67-0.80). MRI had a sensitivity of 0.52 (95% CI 0.41-0.64), specificity 0.89 (95% CI 0.82-0.96), and AUROC of 0.72 (95% CI 0.66-0.77). PET/MRI had a sensitivity of 0.83 (95% CI 0.74-0.94), specificity of 0.57 (95% CI 0.44-0.69), and AUROC of 0.77 (95% CI 0.71-0.84). At follow-up, PET and MRI scores decreased, and the change in MRI was able to identify patients with a clinical response. The accuracy of the PET/MRI scan in detecting inflammation in the terminal ileum and colon was moderate and not superior to either modality alone. With technological advances and combined reading, PET/MRI may still be valuable in selected cases.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microvascular effects of a mixed meal tolerance test: a model validation study.","authors":"Sebastiaan J W van Kraaij, Boukje C Eveleens Maarse, Femke P M Hoevenaars, Ines Warnke, Marieke L de Kam, Matthijs Moerland, Pim Gal","doi":"10.1111/cpf.12904","DOIUrl":"https://doi.org/10.1111/cpf.12904","url":null,"abstract":"<p><strong>Purpose: </strong>Endothelial dysfunction is a pathophysiological change preceding many cardiovascular events. Measuring improvements of endothelial function is challenging when function is already optimal, which may be remediated using a physiological challenge. This study aimed to determine whether imaging assessments can detect microvascular effects of a mixed meal tolerance test (MMTT).</p><p><strong>Methods: </strong>Twenty healthy volunteers (age ≥45 and ≤70 years) underwent two MMTTs at the beginning (Day 1) and end (Day 84) of a twelve-week period. Imaging methods included laser speckle contrast imaging (LSCI) combined with post-occlusive reactive hyperaemia (PORH) and local thermal hyperaemia (LTH) challenges, passive leg movement ultrasonography (PLM), and sidestream dark field microscopy (SDFM). Measurements were conducted pre-MMTT and at 5 timepoints post-MMTT for PLM and SDFM and 3 timepoints post-MMTT for PORH and LTH.</p><p><strong>Results: </strong>No consistent effects of the MMTT were detected on LSCI LTH, PLM and SDFM endpoints. LSCI PORH maximum perfusion was significantly suppressed 46, 136, and 300 min post-MMTT administration on Day 1, while residual perfusion decreased significantly 46 and 136 min post-MMTT on Day 1. However, when repeated on Day 84, PORH endpoints were not significantly affected by the MMTT.</p><p><strong>Conclusion: </strong>SDFM, PLM and LSCI LTH endpoints displayed high intra-subject variability and did not detect consistent effects of MMTT. LSCI PORH endpoints displayed the lowest intra-subject variability of all assessed endpoints and were affected by the MMTT on Day 1, but not on Day 84. Further standardization of methods or more robust challenges to affect vascular endpoints may be needed.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Effects of dehydration on central blood pressure in young healthy adults’","authors":"Madeleine L. Giddings, Jacob P. Auringer, Nathan F. Meier, Elizabeth C. Lefferts, Chong Wang, Lindsay Kane‐Barnese","doi":"10.1111/cpf.12902","DOIUrl":"https://doi.org/10.1111/cpf.12902","url":null,"abstract":"PurposeBrachial blood pressure (BP) is the current gold standard for BP assessment; however, measures of pulse wave velocity (PWV) and central blood pressure (CBP) may contribute uniquely to assessment of cardiovascular health status. As of yet, standards for assessment of CBP and PWV have not addressed the impact of hydration status on proper measurement. To understand the impact of hydration, PWV and CBP should be measured in a euhydrated and hypohydrated state.MethodsForty‐three young, healthy participants (21 ± 2 years) completed a dehydration protocol utilizing moderate aerobic activity until they lost 1%–2% of their body weight. PWV and CBP were measured before and following the dehydration protocol. Linear regression was utilized to assess change in hydration status and change in PWV and CBP.ResultsNo significant relationships were observed between the change in hydration status (% body weight lost) and PWV (<jats:italic>β</jats:italic> = 0.05, <jats:italic>p</jats:italic> = 0.78) or central diastolic BP (<jats:italic>β</jats:italic> = −3.8, <jats:italic>p</jats:italic> = 0.10), however, a significant relationship was observed with central systolic BP (<jats:italic>β</jats:italic> = −5.0, <jats:italic>p</jats:italic> = 0.03).DiscussionIn conclusion, the assessment of hydration status before measurement of CBP or PWV may not be necessary in young, healthy individuals.","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"7 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The concurrent validity of a portable ultrasound probe for muscle thickness measurements.","authors":"Kai A Homer, Matt R Cross, Ivan Jukic","doi":"10.1111/cpf.12901","DOIUrl":"https://doi.org/10.1111/cpf.12901","url":null,"abstract":"<p><p>Ultrasound imaging is extensively used by both practitioners and researchers in assessing muscle thickness (MT); however, its use in the field is constrained by the transportability of stationary devices. New portable ultrasound probes pose as a cost-effective and transportable alternative for field-based assessments. This study evaluated the concurrent validity of a portable probe (Lumify) against a laboratory-based device (Vivid S5) in measuring MT. Eighteen participants (nine males and nine females) visited the laboratory and their MT measurements were collected using each device at five different sites (anterior and posterior arm, anterior and posterior thigh, and posterior lower leg). Bland-Altman plots (systematic and proportional bias, random error, and 95% limits of agreement), Pearson's product-moment correlation coefficient (r), and paired samples t-tests with Cohen's d effect sizes (ES) were used to assess the concurrent validity of the Lumify device. Systematic bias was low at all sites ( ≤ 0.11 cm) while proportional bias was detected only at the posterior lower leg (r² = 0.217 [r = 0.466]). The difference in MT between devices was significant only at the anterior thigh (p < 0.05); however, ES for all sites were considered trivial (ES ≤ 0.131). Linear associations were found between the devices at each site of measurement (r ≥ 0.95). These results highlight that the Lumify probe can be used interchangeably with the Vivid S5 for MT measurements, providing practitioners and researchers with a more cost-effective and portable alternative for field-based assessments.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tortuosity of the left anterior descending artery is associated with hypertension and is not independently related to physical performance: A cardiac computed tomography study","authors":"Alaa Sharfo,&nbsp;Malthe Faurschou Wandall-Holm,&nbsp;Jesper James Linde,&nbsp;Ida Hæsum,&nbsp;Graversen Peter Laursen,&nbsp;Klaus Fuglsang Kofoed,&nbsp;Jens Dahlgaard Hove","doi":"10.1111/cpf.12900","DOIUrl":"10.1111/cpf.12900","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Coronary tortuosity (CorT) is frequently observed in invasive angiography, though its aetiology and clinical significance remain ambiguous. Prior research has indicated possible links between CorT and factors such as hypertension, age, and calcium scores in the left anterior descending (LAD) artery. The aim of this study was to examine and optimize the usage of coronary computed tomography angiography (CCTA) with vessel tracking to explore these associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Observational sub-study of the single centre randomised controlled CATCH-trial. From the original study 600 participants, who underwent CCTA, 250 were randomly selected. Clinical data and patient risk factors were sourced from medical records and structured interviews. Tortuosity of the LAD was quantified by calculating the ratio of the actual vessel-length to the straight-line distance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final study population comprised 194 patients (56 patients were excluded due to poor image quality or inability to perform adequate vessel tracking). After adjusting for confounding variables, tortuosity was significantly associated with hypertension (<i>p</i> &lt; 0.001), female gender (<i>p</i> = 0.01), and increasing age (<i>p</i> = 0.045). No significant correlation was observed between CorT and calcium scores. Univariate analysis indicated that higher CorT levels were linked to lower metabolic equivalents of task (METs) in bicycle tests (<i>p</i> = 0.003); however, this relationship became nonsignificant (<i>p</i> = 0.97) upon adjustment for age, gender, and hypertension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that increased CorT is most prevalent in patients with hypertension, advancing age, and female gender. Although higher tortuosity levels did not significantly impact METs during physical activity, further research is warranted to explore the underlying mechanisms of this relationship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 6","pages":"463-470"},"PeriodicalIF":1.3,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short- and long-term prognostic performance of exercise ECG and myocardial perfusion SPECT","authors":"M. Kraen,&nbsp;S. Akil,&nbsp;B. Hedén,&nbsp;B. Kjellström,&nbsp;J. Berg,&nbsp;E. Ostenfeld,&nbsp;H. Arheden,&nbsp;M. Carlsson,&nbsp;H. Engblom","doi":"10.1111/cpf.12899","DOIUrl":"10.1111/cpf.12899","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Myocardial perfusion SPECT (MPS) and exercise electrocardiography (Ex-ECG) results are of prognostic importance for short-term follow up duration. However, the value of MPS or Ex-ECG findings for long-term risk assessment is less evident as underlying risk factors for ischemic heart disease (IHD) gain in importance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the short- and long-term prognostic value of MPS and Ex-ECG in relation to known risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Materials</h3>\u0000 \u0000 <p>An observational study of 908 patients (age 63 years, 49% male, 45% prior IHD) referred for MPS and Ex-ECG. Follow-up was divided into two periods (short-term: &lt;5 years and long-term: &gt;5 years). Cardiac events were defined as a composite of acute myocardial infarction, unstable angina, unplanned revascularization and cardiovascular death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The composite endpoint occurred in 95 patients (short-term follow up) and in 94 patients (long-term follow up). In multivariable models stress testing had a strong predictive value for short-term follow up (HR for MPS = 2.9, CI = 1.9–4.5, <i>p</i> &lt; 0.001 and HR for Ex-ECG = 2.1, CI 1.3–3.3, <i>p</i> = 0.002), but no predictive value for long-term follow up (HR for MPS = 0.9, CI = 0.5–1.5, <i>p</i> = 0.70 and HR for Ex-ECG = 1.0, CI = 0.6–1.6, <i>p</i> = 0.92). Male sex and prior IHD were significant predictors regardless of follow up duration. Age, diabetes and decreased exercise capacity were risk factors for long-term follow up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prognostic value of MPS and Ex-ECG results are strong for short-term follow up but diminish over time and do not contribute significantly in multivariable models after 5 years. Long-term prognosis is primarily governed by underlying risk factors and exercise capacity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 6","pages":"454-462"},"PeriodicalIF":1.3,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12899","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of moderate-intensity aerobic exercise in combined hypoxic and hot conditions on endothelial function","authors":"Takuma Morishima,&nbsp;Keiichi Yamaguchi,&nbsp;Kazushige Goto","doi":"10.1111/cpf.12894","DOIUrl":"10.1111/cpf.12894","url":null,"abstract":"<p>There is no study that has investigated the impact of exercise in a combined hypoxic and hot environment on endothelial function. Therefore, we tested whether aerobic exercise in a combined hypoxic and hot conditions induces further enhancement of endothelial function. Twelve healthy males cycled at a constant workload (50% of their maximal oxygen uptake under normoxic/thermoneutral conditions) for 30 min in four different environments: exercise under normoxic condition (NOR: fraction of inspiratory oxygen or FiO₂ = 20.9%, 20°C), exercise under hypoxic condition (HYP: FiO₂ = 14.5%, 20°C), exercise under hot condition (HOT: FiO₂ = 20.9%, 30°C), and exercise under combined hypoxia and hot conditions (HH: FiO₂ = 14.5%, 30°C). Before, during, and after exercise, cardiovascular variables (e.g., heart rate, blood flow, and shear rate), blood variables, and endothelial function evaluated by flow-mediated dilation (FMD) were assessed. Heart rates were significantly higher throughout the HH trial's experimental period than the other trials (<i>p</i> &lt; 0.05). However, in the HH trial, brachial artery blood flow and shear rate did not differ from those in other trials after exercise. Plasma catecholamines (epinephrine, norepinephrine, and dopamine) elevations in response to exercise were significantly higher in the HH trial than in the other three trials (<i>p</i> &lt; 0.05). No considerable differences were observed in FMD responses among trials before and after the exercise. In conclusion, aerobic exercise in a combined hot and hypoxic environment further activated sympathetic nervous activity but did not considerably enhance blood flow, shear rate, or endothelial function.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 6","pages":"415-425"},"PeriodicalIF":1.3,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12894","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation of changes in peak expiratory flow (PEF) and forced expiratory volume in 1 s (FEV1) during bronchoconstriction","authors":"Leon L. Csonka,&nbsp;Antti Tikkakoski,&nbsp;Liisa Vuotari,&nbsp;Jussi Karjalainen,&nbsp;Lauri Lehtimäki","doi":"10.1111/cpf.12898","DOIUrl":"10.1111/cpf.12898","url":null,"abstract":"<p>Diagnosis of asthma can be confirmed based on variability in peak expiratory flow (PEF) or changes in forced expiratory volume in 1 s (FEV₁) measured with spirometry. Our aim was to use methacholine challenge as a model of induced airway obstruction to assess how well relative changes in PEF reflect airway obstruction in comparison to relative changes in FEV₁. We retrospectively studied 878 patients who completed a methacholine challenge test. To assess congruency along with differences between relative changes in FEV₁ and PEF during airway obstruction, a regression analysis was performed, and a Bland &amp; Altman plot was constructed. ROC analysis, sensitivity, specificity, positive and negative predictive values and <i>κ</i>-coefficient were used to analyze how decrease in PEF predicts decrease of 10% or 15% in FEV₁. The relative change in PEF was on average less than the relative change in FEV₁. In the ROC analysis areas under the curve were 0.844 and 0.893 for PEF decrease to predict a 10% and 15% decrease in FEV₁, respectively. The agreement between changes in PEF and FEV₁ varied from fair to moderate. Airway obstruction detected by change in PEF was false in about 40% of cases when compared to change in FEV₁. Change in PEF is not a very accurate measure of airway obstruction when compared to change in FEV₁. Replacing peak flow metre with a handheld spirometer might improve diagnostic accuracy of home monitoring in asthma.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"44 6","pages":"447-453"},"PeriodicalIF":1.3,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.12898","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}