Bronchodilator response in FVC is larger and more relevant than in FEV 1 in severe airflow obstruction

Background

Recommendations on interpreting tests of bronchodilator responsiveness (BDR) are conflicting. We investigated the dependence of BDR criteria on sex, age, height, ethnicity and severity of respiratory impairment.

Methods

BDR tests were available from clinical patients in the Netherlands, New Zealand and the USA (N=15,278, 51.7% females) and surveys in Canada, Norway and five Latin-American countries (N=16,250, 54.7% females). BDR in FEV1, FVC and FEV1/ FVC was expressed as absolute change, % baseline, % predicted and z-score.

Results

Change (Δ) in FEV1 and FVC in mL was unrelated to the baseline value but biased towards age, height, sex and level of airways obstruction; ΔFEV1 was significantly lower in African Americans. In 1106 subjects with a low FEV1 (200-1621mL) the FEV1 increased 12-44.7% baseline but Conclusions

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