Open Journal of Respiratory Diseases, 2012, 2, 31-36
http://dx.doi.org/10.4236/ojrd.2012.22005 Published Online May 2012 (http://www.SciRP.org/journal/ojrd)
Should We Measure the FEV
1
or the Specific Resistance of
the Airways? An Evaluation in Patients with Either
COPD, Chronic Dyspnea or Chronic Cough
*
Kinga Simon
1
, Viviane De Maertelaer
2
, André Noseda
1
1
The Pulmonary Division, CHU Brugmann, Brussels, Belgium
2
IRIBHN and Department of Biostatistics and Medical Informatics (SBIM), Université Libre de Bruxelles, Brussels, Belgium
Email: andre.noseda@chu-brugmann.be
Received December 27, 2011; revised February 3, 2012; accepted February 13, 2012
ABSTRACT
Background: The purpose of this study was to evaluate the relative contribution of measuring the forced expiratory
volume in one second (FEV
1
) or the specific resistance of the airways (sRaw) in adults referred for chronic obstructive
pulmonary disease (COPD), chronic dyspnea or chronic cough. Methods: This was a prospective study of 321 subjects
referred for lung function testing, in a setting of routine clinical management, for suspicion of COPD (or follow-up of
known COPD), chronic dyspnea or chronic cough. The proportions of FEV
1
values below the normal range and of
sRaw values above the normal range were compared using a Chi-square exact test of Fisher. Results: In the COPD and
chronic dyspnea groups, sRaw was as frequently abnormal as FEV
1
. In the chronic cough group, sRaw was increased in
56.5% of subjects, while FEV
1
was decreased in solely 34.8% (p = 0.059). Conclusions: This study suggests that sRaw
may be a better tool than FEV
1
to detect bronchial obstruction in patients presenting with chronic cough.
Keywords: Body Plethysmography; Chronic Cough; Specific Airway Resistance
1. Introduction
Spirometry is often considered as the gold standard for
determination of obstructive pulmonary disease. This
method has however several limitations, which has led to
resistance measurements used to clarify lung pathophysi-
ology [1]. In the recent years, there has been a progres-
sive disinterest in resistance measurements, at least in
adults. As an illustration, the 2005 American Thoracic
Society and European Respiratory Society statements did
not address resistance measurements [2]. In contrast,
resistance measurements are still considered to be par-
ticularly relevant in pediatric patients [3,4].
The present study was designed to evaluate the relative
contribution of measuring the forced expiratory volume
in one second (FEV
1
) or the specific resistance of the
airways (sRaw) in adults referred for lung function test-
ing (LFT) because of chronic obstructive pulmonary dis-
ease (COPD), chronic dyspnea or chronic cough. These
indications were chosen because the Belgian authorities
recently suggested that the usefulness of assessing airway
resistance is not proven in subjects with either COPD,
chronic dyspnea or chronic cough [5]. We hypothesized
that sRaw may be more sensitive than FEV
1
in detecting
bronchial obstruction in these groups of patients. The
study was performed in a setting of routine clinical man-
agement and aimed to evaluate the percentage of subjects
with an abnormal test, namely a decreased FEV
1
or an
increased sRaw.
2. Patients and Methods
2.1. Study Design
In the present study, we prospectively evaluated the sRaw
and the FEV
1
in three groups of subjects (as defined un-
derneath) in a setting of routine clinical management.
The patients were referred by their physician for LFT
because of either COPD (group 1), chronic dyspnea (group
2) or chronic cough (group 3). The study protocol was
approved by the Ethics Committee of the CHU Brug-
mann and each subject gave written informed consent to
the analysis of his (her) lung function data.
2.2. Patients
The study was performed at the Pulmonary Division of
the CHU Brugmann between 26/10/2009 and 16/07/2010.
All males and females between 18 and 70 years old, re-
ferred for LFT because of COPD, chronic dyspnea or
chronic cough, were eligible provided they gave in-
formed consent and were able to perform technically
*
Conflict of interest: There is no conflict of interest.
Copyright © 2012 SciRes. OJRD