title: Bronchial reactivity indices are determinants of health-related quality of life in patients with stable asthma.
abstract: BACKGROUND
  A very weak relationship has been reported between the health-related quality of life (HRQL) of patients with asthma and their degree of airway hyper-responsiveness (AHR), evaluated in terms of sensitivity. However, this relationship still has not been sufficiently explored for bronchial reactivity indices.
  
  
  OBJECTIVE
  To analyse the relationship between bronchial reactivity and sensitivity with the HRQL of patients with stable asthma, identifying the functional parameters that determine HRQL.
  
  
  METHODS
  In 103 consecutive patients with stable asthma, HRQL was evaluated using the Asthma Quality of Life Questionnaire (AQLQ). Patients underwent spirometry and non-specific bronchial provocation with methacoline. Sensitivity (PD(20)) and reactivity (dose-response slope (DRS), continuous index of responsiveness (CIR) and bronchial reactivity index (BRI)) of the dose-response curve were analysed.
  
  
  RESULTS
  BRI presented significant differences with different degrees of asthma severity. Although patients with AHR showed poorer quality of life than patients without AHR, the AQLQ total score was not related to PD(20) but rather to DRS (r=-0.784), CIR (r=-0.712) and BRI (r=-0.776). The indices of bronchial reactivity reached a negative correlation with all the domains of the AQLQ. In a multiple linear regression model, BRI, DRS, FIV(1) (forced inspiratory volume in 1 s) and VCIN (inspiratory vital capacity) were identified as independent predictors of the AQLQ total score (r(2)=0.742, p<0.001).
  
  
  CONCLUSIONS
  In patients with stable asthma, bronchial reactivity is associated with HRQL. This could justify incorporating bronchial reactivity indices in bronchial provocation analyses.
authors.affiliation: Servicio de Neumología, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Hospital Princesa, Madrid, Spain. carol9199@yahoo.es
authors.forename: Carolina
authors.initials: C
authors.lastname: Cisneros
authors.forename: Francisco
authors.initials: F
authors.lastname: García-Río
authors.forename: Delia
authors.initials: D
authors.lastname: Romera
authors.forename: Carlos
authors.initials: C
authors.lastname: Villasante
authors.forename: Rosa
authors.initials: R
authors.lastname: Girón
authors.forename: Julio
authors.initials: J
authors.lastname: Ancochea
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000503:physiopathology* / Q000534:rehabilitation; D016535:Bronchial Hyperreactivity / Q000503:physiopathology* / Q000534:rehabilitation; D001985:Bronchial Provocation Tests / Q000379:methods; D016085:Bronchoconstrictor Agents; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006304:Health Status; D006801:Humans; D008297:Male; D016210:Methacholine Chloride; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D012129:Respiratory Function Tests / Q000379:methods; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult
chemical_list: D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride