KMID : 1225720170090030229
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Allergy, Asthma & Immunology Research : AAIR 2017 Volume.9 No. 3 p.229 ~ p.236
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Is Performance of a Modified Eucapnic Voluntary Hyperpnea Test in High Ventilation Athletes Reproducible?
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Kennedy Michael D.
Steinback Craig D. Skow Rachel Parent Eric C.
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Abstract
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Purpose: Exercise-induced bronchoconstriction (EIB) is common in ¡°high ventilation¡± athletes, and the Eucapnic Voluntary Hyperpnea (EVH) airway provocation test is the standard EIB screen. Although the EVH test is widely used, the in-test performance in high ventilation athletes as well as the reproducibility of that performance has not been determined. Reproducibility of pre- and post-test spirometry and self-reported atopy/cough was also examined.
Methods: High ventilation athletes (competitive swimmers; n=11, 5 males) completed an atopy/cough questionnaire and EVH testing (operator controlled FiCO2) on 2 consecutive days.
Results: Swimmers achieved 85%¡¾9% and 87%¡¾9% of target FEV1 volume on days 1 and 2, respectively, (P=0.45; ICC 0.57 [0.00-0.86]) resulting in a total ventilation of 687 vs 684 L [P=0.89, ICC 0.89 (0.65-0.97]) equating to 83%¡¾8% and 84%¡¾9% of predicted total volume (ICC 0.54 [0.00-0.85]) between days 1 and 2. FiCO2 required to maintain eucapnic conditions was 2.5%. Pre-test FEV1 was less on day 2 (P=0.04; ICC >0.90). Day 1 to 2 post-test FEV1 was not different, and 4 swimmers were EIB positive (>10% fall in pre-post FEV1) on day 1 (3 on day 2).
Conclusions: EVH in-test performance is reproducible however required less FiCO2 than standard protocol and the swimmers under-ventilated by 125 and 139 L/min for days 1 and 2, respectively. How this affects EIB diagnosis remains to be determined; however, our results indicate a post-test FEV1 fall of ¡Ã20% may be recommended as the most consistent diagnostic criterion.
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KEYWORD
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Exercise-Induced Bronchospasm, airway hyper-responsiveness, cough, swimming
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