The diagnostic value of combined pulmonary function test and exhaled nitric oxide monitoring in cough variant asthma with or without gastroesophageal reflux disease: a retrospective study

Abstract Introduction This study aimed to investigate the effect of fractional exhaled nitric oxide (FeNO), a marker of airway inflammation, together with small airway function tests in diagnosing cough variant asthma (CVA), particularly in patients with gastroesophageal reflux disease (GERD). Metho...

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Main Authors: Sen Li, Siyao Xu, Yuan Yang, Zhe Wang, Yaru Hou
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-025-03636-7
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author Sen Li
Siyao Xu
Yuan Yang
Zhe Wang
Yaru Hou
author_facet Sen Li
Siyao Xu
Yuan Yang
Zhe Wang
Yaru Hou
author_sort Sen Li
collection DOAJ
description Abstract Introduction This study aimed to investigate the effect of fractional exhaled nitric oxide (FeNO), a marker of airway inflammation, together with small airway function tests in diagnosing cough variant asthma (CVA), particularly in patients with gastroesophageal reflux disease (GERD). Methods This retrospective cohort study included adult patients with chronic cough for more than eight weeks who were divided into a CVA group and a control group. Participants underwent pulmonary function tests and FeNO measurements. Statistical tests and ROC curve analysis were used to assess diagnostic accuracy. Results CVA patients had higher FeNO levels than controls, regardless of with or without GERD. There were no significant differences in FEV1, FVC, and FEV1/FVC ratio between the control and CVA groups, but CVA patients had significantly lower MEF25, MEF50, MEF75, and MMEF values. FeNO was negatively correlated with MEF50, MEF75, and MMEF. The AUC of FeNO in diagnosing CVA was 0.862. Combining FeNO with MMEF resulted in the highest diagnostic accuracy (AUC = 0.909). The diagnostic benefits of FeNO and FeNO + MMEF were similar in GERD patients. Conclusion Combining FeNO with small airway function tests, especially MMEF, can improve the diagnostic accuracy of CVA, while FeNO and FeNO + MMEF performed similar diagnostic accuracy in patients with GERD. Clinical trial number Not applicable.
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spelling doaj-art-19f5c80bb1fa426894f945fbe6a5432d2025-08-20T02:17:04ZengBMCBMC Pulmonary Medicine1471-24662025-04-012511710.1186/s12890-025-03636-7The diagnostic value of combined pulmonary function test and exhaled nitric oxide monitoring in cough variant asthma with or without gastroesophageal reflux disease: a retrospective studySen Li0Siyao Xu1Yuan Yang2Zhe Wang3Yaru Hou4Department of Respiratory and Critical Care Medicine, HanZhong Central HospitalDepartment of Respiratory and Critical Care Medicine, HanZhong Central HospitalDepartment of Respiratory and Critical Care Medicine, HanZhong Central HospitalDepartment of Respiratory and Critical Care Medicine, HanZhong Central HospitalDepartment of Respiratory and Critical Care Medicine, HanZhong Central HospitalAbstract Introduction This study aimed to investigate the effect of fractional exhaled nitric oxide (FeNO), a marker of airway inflammation, together with small airway function tests in diagnosing cough variant asthma (CVA), particularly in patients with gastroesophageal reflux disease (GERD). Methods This retrospective cohort study included adult patients with chronic cough for more than eight weeks who were divided into a CVA group and a control group. Participants underwent pulmonary function tests and FeNO measurements. Statistical tests and ROC curve analysis were used to assess diagnostic accuracy. Results CVA patients had higher FeNO levels than controls, regardless of with or without GERD. There were no significant differences in FEV1, FVC, and FEV1/FVC ratio between the control and CVA groups, but CVA patients had significantly lower MEF25, MEF50, MEF75, and MMEF values. FeNO was negatively correlated with MEF50, MEF75, and MMEF. The AUC of FeNO in diagnosing CVA was 0.862. Combining FeNO with MMEF resulted in the highest diagnostic accuracy (AUC = 0.909). The diagnostic benefits of FeNO and FeNO + MMEF were similar in GERD patients. Conclusion Combining FeNO with small airway function tests, especially MMEF, can improve the diagnostic accuracy of CVA, while FeNO and FeNO + MMEF performed similar diagnostic accuracy in patients with GERD. Clinical trial number Not applicable.https://doi.org/10.1186/s12890-025-03636-7Asthma diagnosisPulmonary function testFractional exhaled nitric oxideCough variant asthmaGastroesophageal reflux disease
spellingShingle Sen Li
Siyao Xu
Yuan Yang
Zhe Wang
Yaru Hou
The diagnostic value of combined pulmonary function test and exhaled nitric oxide monitoring in cough variant asthma with or without gastroesophageal reflux disease: a retrospective study
BMC Pulmonary Medicine
Asthma diagnosis
Pulmonary function test
Fractional exhaled nitric oxide
Cough variant asthma
Gastroesophageal reflux disease
title The diagnostic value of combined pulmonary function test and exhaled nitric oxide monitoring in cough variant asthma with or without gastroesophageal reflux disease: a retrospective study
title_full The diagnostic value of combined pulmonary function test and exhaled nitric oxide monitoring in cough variant asthma with or without gastroesophageal reflux disease: a retrospective study
title_fullStr The diagnostic value of combined pulmonary function test and exhaled nitric oxide monitoring in cough variant asthma with or without gastroesophageal reflux disease: a retrospective study
title_full_unstemmed The diagnostic value of combined pulmonary function test and exhaled nitric oxide monitoring in cough variant asthma with or without gastroesophageal reflux disease: a retrospective study
title_short The diagnostic value of combined pulmonary function test and exhaled nitric oxide monitoring in cough variant asthma with or without gastroesophageal reflux disease: a retrospective study
title_sort diagnostic value of combined pulmonary function test and exhaled nitric oxide monitoring in cough variant asthma with or without gastroesophageal reflux disease a retrospective study
topic Asthma diagnosis
Pulmonary function test
Fractional exhaled nitric oxide
Cough variant asthma
Gastroesophageal reflux disease
url https://doi.org/10.1186/s12890-025-03636-7
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