136165

Use of Area under the Expiratory Flow-volume Curve and Rectangular Area Ratio in Detecting Ventilatory Impairments in Spirometry: A Pilot Study

Article

Last updated: 03 Jan 2025

Subjects

-

Tags

Respiratory Physiology

Abstract

Purpose: This study aimed at demonstrating the reliability of surface area under the maximum expiratory flow volume curve (Aex) and rectangular area ratio (RAR) to define the type of ventilatory impairment and assessing potential clinical value of Aex ratio (measured / predicted Aex) to indicate the severity of ventilatory obstruction. Methods: Spirometric data of 75 subjects were analyzed by qualified pulmonologists to distinguish between different spirometric patterns representing expert decision. Computerized graphic analysis methodology was used, Aex was used to calculate other parameters (area of concavity and RAR) and an algorithm for diagnosis was proposed. For validation of the proposed grading and cutoff values, we compared them with expert decision using classification and regression trees (CART). Results: According to calculated parameters, obstructive pattern is realized if area of concavity (Au) has positive value and RAR is less than 0.5. While convexity/linearity is indicated if RAR ≥ 0.5 and Au has negative value or equal zero, indicating normal or restrictive pattern. Aex ratio was selected as second-best predictor of restriction at a cut-off value of 49%. Furthermore, the diagnostic performance of Aex ratio in predicting moderate-to-severe obstructive lung disease was excellent. Conclusion: The proposed computerized technique succeeded using RAR and Aex in differentiating between restriction, obstruction and normal patterns. Additionally, Aex ratio may be a valid parameter to grade the severity of obstruction.

DOI

10.21608/besps.2020.35867.1068

Keywords

Spirometry, flow-volume curve, rectangular area ratio (RAR), ventilatory impairment, Aex ratio

Authors

First Name

Ibrahim

Last Name

El-Akkary

MiddleName

-

Affiliation

Department of Human Physiology, Medical Research Institute, Alexandria University, Alexandria, Egypt

Email

iakkary@hotmail.com

City

Alexandria

Orcid

-

First Name

Eman

Last Name

Khairy

MiddleName

Y.

Affiliation

Department of Human Physiology, Medical Research Institute, Alexandria University, Egypt.

Email

eman23475@yahoo.com

City

Alexandria

Orcid

-

First Name

Ola

Last Name

Salama

MiddleName

A.

Affiliation

Department of Human Physiology, Medical Research Institute, Alexandria University, Egypt.

Email

ola_a_salama@yahoo.com

City

Alexandria

Orcid

-

First Name

Ghada

Last Name

Abu-Sheasha

MiddleName

-

Affiliation

Department of Biomedical informatics and Medical Statistics, Medical Research Institute, Alexandria University, Egypt

Email

gsheasha@yahoo.com

City

Alexandria

Orcid

-

First Name

Nancy

Last Name

Diaa Moussa

MiddleName

-

Affiliation

Medical Research Institute, Alexandria University

Email

nancy.diaaeldin.moussa@gmail.com

City

Alexandria

Orcid

-

Volume

41

Article Issue

2

Related Issue

19685

Issue Date

2021-04-01

Receive Date

2020-07-15

Publish Date

2021-04-01

Page Start

258

Page End

269

Print ISSN

1110-0842

Online ISSN

2356-9514

Link

https://besps.journals.ekb.eg/article_136165.html

Detail API

https://besps.journals.ekb.eg/service?article_code=136165

Order

9

Type

Original Article

Type Code

567

Publication Type

Journal

Publication Title

Bulletin of Egyptian Society for Physiological Sciences

Publication Link

https://besps.journals.ekb.eg/

MainTitle

Use of Area under the Expiratory Flow-volume Curve and Rectangular Area Ratio in Detecting Ventilatory Impairments in Spirometry: A Pilot Study

Details

Type

Article

Created At

22 Jan 2023