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FEV1 response to bronchodilation in an adult urban population

Division of Pulmonary Medicine, Department of Medicine, Helsinki University Central Hospital, P.O. Box 340, FIN-00029 HUS, Helsinki, Finland, Tel: +358-40-735 2763, Fax: +358-9-4717 4592; Research Unit of Pulmonary Diseases, Department of Medicine, Helsinki University Central Hospital and Clinical Research Institute Ltd, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland; Unit for Lung and Allergy Research, National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Division of Clinical Physiology and Nuclear Medicine, Laboratory Department, Helsinki University Central Hospital, Helsinki, Finland

annette.kainu{at}fimnet.fi

Abstract

BackgroundMost studies evaluating bronchodilation in flow-volume spirometry have been conducted in patients with obstructive airways diseases, but less is known about bronchodilation responses in the general population or in healthy subjects.

MethodsWe evaluated an urban population sample of 628 adults (260 men, 368 women) aged 25-74 years with flow-volume spirometry using 0.4 mg of inhaled salbutamol aerosol with a spacer device for bronchodilation. On the basis of a structured interview, a subgroup of 219 healthy asymptomatic non-smokers was selected.

ResultsIn the population sample, the average increase of forced expiratory volume in one second (FEV1) from baseline after inhaled salbutamol was 77.2 ml (s.d. 109.7 ml) or 2.5% (3.9%). In healthy asymptomatic non-smokers, the mean change of FEV1 was 62.0 ml (89.7 ml) or 1.8% (2.6%). In the whole population, the 95^th percentile limit of the increase of FEV1 was 8.5%, while it was 5.9% among healthy asymptomatic non-smokers. The absolute change of FEV1 correlated significantly with the baseline FVC (p<0.01). The ratio of FEV1 to forced vital capacity (FEV1/FVC) at baseline was the strongest influencing factor for bronchodilation response.

ConclusionsThe results indicate that a significant increase of FEV1 from the baseline in a bronchodilation test is around 9% in an urban population. The level of the significant absolute increase of FEV1 seems to depend on FVC. Low baseline FEV1/FVC, reflecting airflow limitation, is the strongest determinant for FEV1 response to bronchodilation.

Key Words: flow-volume spirometry • FEV1 • bronchodilation • lung function