Kennedy Michael D, Steinback Craig D, Skow Rachel, Parent Eric C
Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada.
Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.
Allergy Asthma Immunol Res. 2017 May;9(3):229-236. doi: 10.4168/aair.2017.9.3.229.
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.
High ventilation athletes (competitive swimmers; n=11, 5 males) completed an atopy/cough questionnaire and EVH testing (operator controlled FiCO₂) on 2 consecutive days.
Swimmers achieved 85%±9% and 87%±9% 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%±8% and 84%±9% 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).
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 ≥20% may be recommended as the most consistent diagnostic criterion.
运动诱发支气管收缩（EIB）在“高通气量”运动员中很常见，等二氧化碳自主过度通气（EVH）气道激发试验是EIB的标准筛查方法。尽管EVH试验被广泛应用，但高通气量运动员在试验中的表现以及该表现的可重复性尚未确定。同时也对试验前后肺活量测定和自我报告的特应性/咳嗽的可重复性进行了检查。
高通气量运动员（竞技游泳运动员；n = 11，5名男性）连续两天完成特应性/咳嗽问卷调查和EVH测试（操作员控制FiCO₂）。
游泳运动员在第1天和第2天分别达到目标FEV1量的85%±9%和87%±9%，（P = 0.45；组内相关系数ICC 0.57 [0.00 - 0.86]），第1天和第2天的总通气量分别为687 L和684 L [P = 0.89，ICC 0.89 (0.65 - 0.97)]，相当于预测总量的83%±8%和84%±9%（ICC 0.54 [0.00 - 0.85]）。维持等二氧化碳条件所需的FiCO₂为2.5%。第2天的测试前FEV1较低（P = 0.04；ICC >0.90）。第1天至第2天的测试后FEV1没有差异，4名游泳运动员在第1天EIB呈阳性（测试前后FEV1下降>10%）（第2天为3名）。
EVH试验中的表现具有可重复性，但所需的FiCO₂低于标准方案，并且游泳运动员在第1天和第2天的通气量分别比标准少125和139 L/分钟。这对EIB诊断的影响尚待确定；然而，我们的结果表明，测试后FEV1下降≥20%可能是最一致的诊断标准。
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