Reproducibility of the bronchoconstrictive response to eucapnic voluntary hyperpnoea

• Published in: Respiratory medicine Vol. 109; no. 10; pp. 1262 - 1267
• Main Authors: Williams, N.C, Johnson, M.A, Hunter, K.A, Sharpe, G.R
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2015; Elsevier Limited
• Subjects: Adult; Asthma; Asthma - diagnosis; Asthma - physiopathology; Asthma, Exercise-Induced - diagnosis; Asthma, Exercise-Induced - physiopathology; Bronchoconstriction - physiology; Case-Control Studies; Cohort Studies; Emphysema; Eucapnic voluntary hyperpnoea; Exercise; Exercise-induced bronchoconstriction; Forced Expiratory Volume - physiology; Gases; Humans; Hyperventilation - physiopathology; Male; Maximal Voluntary Ventilation; Pulmonary/Respiratory; Reproducibility; Reproducibility of Results; Short term; Ventilation; Vital Capacity - physiology; Eucapnic voluntary hyperpnoea; HIB; V ˙ E; Exercise-induced bronchoconstriction; hyperpnoea-induced bronchoconstriction; smallest meaningful change; forced expiratory volume in 1 s; forced vital capacity; SMC; area under the curve; MVV; maximal voluntary ventilation; Asthma; minute ventilation; AUC; FVC; FEV 1; CV; Reproducibility; EVH; EIB; coefficient of variation; V˙E; FEV1
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2015.08.006

Abstract Background Eucapnic voluntary hyperpnoea (EVH) is considered an effective bronchoprovocation challenge for identifying exercise-induced bronchoconstriction (EIB). However, the reproducibility of the hyperpnoea-induced bronchoconstriction (HIB) response elicited by EVH remains unknown and was therefore the focus of this study. Methods Two cohorts of 16 physically active males (each cohort comprised 8 controls and 8 with physician diagnosis of asthma) participated in two studies of the short- and long-term reproducibility of the bronchoconstrictive response to an EVH test with dry air. EVH was performed on days 0, 7, 14, and 21 (short-term study), and 0, 35, and 70 (long-term study). HIB was diagnosed by a ≥10% fall in forced expiratory volume in 1 s (FEV1 ) after EVH. Results On day 0 of the short-term study, FEV1 fell by 2 ± 1% ( P  < 0.05) and 27 ± 18% ( P  < 0.01) from pre-to post-EVH in control and HIB-positive groups respectively. The post-EVH fall in FEV1 did not differ across the short-term study test days. In the HIB-positive group, the day-to-day coefficient of variation, reproducibility, and smallest meaningful change for the fall in FEV1 were 12%, 328 mL, and 164 mL, respectively. On day 0 of the long-term study, FEV1 fell by 2 ± 2% and 25 ± 18% ( P  < 0.01) after EVH in control and HIB-positive groups respectively. The post-EVH fall in FEV1 did not differ across the long-term study test days. In the HIB-positive group, the day-to-day coefficient of variation, reproducibility, and smallest meaningful change for the fall in FEV1 were 10%, 196 mL, and 98 mL respectively. Conclusion The EVH test elicits a reproducible bronchoconstrictive response in physically active males with physician diagnosed asthma. These data thus support the clinical utility of the EVH test for EIB screening and monitoring.