Holley Aaron B, Cohee Brian, Walter Robert J, Shah Anita A, King Christopher S, Roop Stuart
Pulmonary/Sleep and Critical Care Medicine, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889, USA.
J Asthma. 2012 Aug;49(6):614-9. doi: 10.3109/02770903.2012.697955.
Response to eucapnic voluntary hyperventilation (EVH) has not been compared with methacholine challenge testing (MCCT) in nonathletes being evaluated for dyspnea on exertion.
To determine the airway response to EVH and MCCT in a population of nonathletes who exercise regularly but have symptoms with exertion.
We reviewed records for all patients with exercise symptoms who underwent both EVH and MCCT. Presenting symptoms, comorbid diseases, and results of bronchoprovocation (BP) testing were recorded. This study was approved by the institutional review board at our hospital.
A total of 131 patients (mean age 32.3 ± 11.6, body mass index (BMI) 27.1 ± 4.7 kg/m(2), 59.5% male) had an EVH, MCCT, and clinical evaluation performed. Overall, 37 (28.2%) patients had positive BP testing and met criteria for exercise-induced bronchoconstriction (EIB). There were 32 (24.4%) patients with a positive EVH, compared with only 11 patients with a positive MCCT (8.4%). There were 26 patients (19.8%) who had a positive EVH but a negative MCCT, and correlation between the two tests was poor to moderate (r = 0.11-0.57). A complaint of chest pain and younger age were independent predictors for a positive EVH, whereas a history of tobacco use and a decreased FEV(1)/FVC (forced expiratory volume in 1 s/forced vital capacity) predicted a positive MCCT. A previous diagnosis of asthma was an independent predictor for a response to either test. Discussion. In a population of nonathletes who exercise regularly and have symptoms with exertion, EIB is common. Correlation between EVH and MCCT in this population is poor, and although the tests are somewhat complementary, a large percentage of patients had a negative MCCT but a positive EVH.
EIB is common in nonathletes with exercise-induced symptoms, and EVH is the preferred test for this population.
EIB is common in nonathletes who exercise regularly. In this population, MCCT will miss most patients with EIB, and MCCT and EVH show only poor-to-moderate correlation.
EVH has not been compared with MCCT in nonathletes without a diagnosis of asthma. Our study shows that the two tests are complementary in this population, but EVH is positive more often.
对于因运动性呼吸困难而接受评估的非运动员，尚未将对等容性自主过度通气（EVH）的反应与乙酰甲胆碱激发试验（MCCT）进行比较。
确定在经常运动但运动时有症状的非运动员人群中，EVH和MCCT的气道反应。
我们回顾了所有接受过EVH和MCCT的有运动症状患者的记录。记录了呈现的症状、合并疾病以及支气管激发（BP）试验的结果。本研究获得了我院机构审查委员会的批准。
共有131例患者（平均年龄32.3±11.6岁，体重指数（BMI）27.1±4.7kg/m²，59.5%为男性）进行了EVH、MCCT及临床评估。总体而言，37例（28.2%）患者BP试验呈阳性且符合运动诱发支气管收缩（EIB）标准。EVH阳性的患者有32例（24.4%），而MCCT阳性的患者仅11例（8.4%）。有26例患者（19.8%）EVH阳性但MCCT阴性，两项试验之间的相关性为差到中等（r = 0.11 - 0.57）。胸痛主诉和较年轻是EVH阳性的独立预测因素，而吸烟史和FEV₁/FVC（1秒用力呼气容积/用力肺活量）降低则预测MCCT阳性。既往哮喘诊断是对任一试验有反应的独立预测因素。讨论。在经常运动且运动时有症状的非运动员人群中，EIB很常见。该人群中EVH与MCCT之间的相关性较差，尽管这两项试验有一定互补性，但很大比例的患者MCCT阴性但EVH阳性。
EIB在有运动诱发症状的非运动员中很常见，且EVH是该人群的首选检查。
EIB在经常运动的非运动员中很常见。在该人群中，MCCT会漏诊大多数EIB患者，且MCCT与EVH仅显示差到中等的相关性。
在未诊断为哮喘的非运动员中，尚未将EVH与MCCT进行比较。我们的研究表明，这两项试验在该人群中具有互补性，但EVH更常呈阳性。
