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Pulmonary Medicine
Volume 2012 (2012), Article ID 797495, 6 pages
Clinical Study

Concave Pattern of a Maximal Expiratory Flow-Volume Curve: A Sign of Airflow Limitation in Adult Bronchial Asthma

1Ohwada Clinic, 4-7-13 Minamiyawata, Ichikawa, Chiba 272-0023, Japan
2Department of Respiratory Medicine, Juntendo University School of Medicine, Tokyo 113-8421, Japan

Received 9 August 2012; Revised 12 October 2012; Accepted 29 October 2012

Academic Editor: Roberto Walter Dal Negro

Copyright © 2012 Akihiko Ohwada and Kazuhisa Takahashi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. In patients with bronchial asthma, spirometry could identify the airflow limitation of small airways by evaluating the concave shape of the maximal expiratory flow-volume (MEFV) curve. As the concave shape of the MEFV curve is not well documented, we reevaluated the importance of this curve in adult asthmatic patients. Methods. We evaluated spirometric parameters, the MEFV curve, and its concave shape (scoop between the peak and endpoint of expiration) in 27 nonsmoking asthmatic patients with physician-confirmed wheeze and positive bronchial reversibility after a short-acting β2-agonist inhalation. We also calculated angle β and shape factors ( and ) to quantitate the curvilinearity of the MEFV curve. Results. The MEFV curve was concave in all patients. Along with improvements in standard spirometric parameters, curvilinear parameters, angle β, , and were significantly improved after bronchodilator inhalation. There were significant correlations between improvements in angle β, and , and , and between improvements in , and , and . Conclusions. The bronchodilator greatly affected the concave shape of the MEFV curve, correlating with spirometric parameters of small airway obstructions ( , , and ). Thus, the concave shape of the MEFV curve is an important indicator of airflow limitation in adult asthmatic patients.