Interpreting New PFT results

[tiancheng]

I am following up from a previous post:

http://www.medhelp.org/posts/Respiratory-Disorders/Recent-onset-SOB-PFT-shows-restrictive-process/show/1022718?camp=27

New symptoms include post-nasal drip and occasional runny nose. Diagnosed with rhinosinusitis.

Here are my new PFT results. As I interpret them, my condition has worsened. My doctor concurs. Note that previous PFT was taking Asmanex. Doctor has now prescribed Singulair, Qvar and a cortisteroid nasal spray.

My questions are:

1. Is this still asthma or something else?

2. If something else, what is it?

3. Why are my lung volumes reduced from the PFT 6 months ago?

4. Why are my Raw and sRaw values increased from the PFT 6 months ago?

5. Any thoughts regarding the drugs prescribed above and length of time that I should take them?

6. Any thoughts regarding alternative combinations and/or therapies?

7. Long term prognosis given past PFT and current?

Thank you.

all values % of predicted (pre bronchidilator/post) except Vt and Vtg.

FVC   87/87
FEV1 77/83
FEV1/FVC 90/95
PEF 110/112
FIV1/FIVC 81/90
FIVC 89/90
MVV 61
TLC   74
VC    91
RV    20
RV/TLC 27
FRC PL 47
ERV 60
IC 90
Vt  1.42
Vtg 4.00
Raw 126
Gaw   74
sRaw 137
sGaw  73
DLCO  106
DL Adj  106
DLCO/VA  117
VA         87

[National Jewish Health]

Greetings, I am confused by the data you have sent.  In your E-mail of August 31, you referred to the PFT data as “Last week I had  a spirometry test and obtained a copy of results.”  Here it is:



August 31, 2009



My FVC was 73%....2.52
FEV1  58%   1.66
FEF 25%/75% was 32%    1.04
FIVC 2.94     85%
PEF  4.37     69%
FEV3   2.33   73%

Post med
FVC 2.69
FEV1  2.01
FEF   1.54
FIVC  2.82
PEF  5.23
FEV3  2.54





Then in your E-mail of September 2, you stated, “Here are my new PFT results”  Are these truly “new PFT results” or the results from 6 months ago.  I assume the latter but need to be sure, as with asthma, PFT results can vary widely from one day to the next.  The  following “new PFT results (FVC   87/87    FEV1 77/83
FEV1/FVC 90/95  are essentially WNL  The TLC of 74%  is borderline, with a decreased MVV of 61 ).    



Please clarify

[tiancheng]

one more question

8. what tests are recommended to rule out differential diagnoses for the symptoms I am experiencing and my last two PFT results?

[tiancheng]

FEV25-75  47/59

[tiancheng]

I apologize if I was not clear.

The PFT results from 2/09, (which I referenced in my original post but did not state when the test was done) are listed here  http://www.medhelp.org/posts/Respiratory-Disorders/Recent-onset-SOB-PFT-shows-restrictive-process/show/1022718?camp=27
and  below:

FVC      87/86
FEV1    86/88
FEV1/FVC  100/103
FEV25-75   68/74
PEF          109/113
FIV1/FIVC   73/80
FIVC           83/83
MVV           44
TLC             87
VC              87
RV              84
RV/TLC       93
FRC            82
ERV            69
IC               90
VE             277
DLC0         105
Dl Adj         105
DLCO/VA    120
VA              85
(although not posted, my resistance values were between 94% and 104%)

The new PFT results from 9/09 are listed here:

FVC   87/87
FEV1 77/83
FEV1/FVC 90/95
FEV25-75  47/59
PEF 110/112
FIV1/FIVC 81/90
FIVC 89/90
MVV 61
TLC   74
VC    91
RV    20
RV/TLC 27
FRC PL 47
ERV 60
IC 90
Vt  1.42
Vtg 4.00
Raw 126
Gaw   74
sRaw 137
sGaw  73
DLCO  106
DL Adj  106
DLCO/VA  117
VA         87

All values are percentages (except Vt and Vtg, I believe) and second value is post-broncho(exdilator.

I am concerned with the low FRC, low RV, lowered FEV25-75, high Raw and SRaw. Please see my original list of questions. Thank you.