Denise Mannée1, Esther Vis2, Aranka Hoekstra-Kuik3, Jan van der Maten3, Alex Jan van 't Hul4, Hanneke van Helvoort4. 1. Pulmonary Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands, Denise.mannee@radboudumc.nl. 2. Pulmonary Diseases, Admiraal de Ruyter Ziekenhuis, Goes, The Netherlands. 3. Pulmonary Diseases, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands. 4. Pulmonary Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands.
Abstract
BACKGROUND: A simple technique to measure dynamic hyperinflation (DH) in patients with chronic obstructive pulmonary disease (COPD) is the metronome-paced tachypnea test (MPT). Earlier studies show conflicting results about the accuracy of the MPT compared to cardiopulmonary exercise testing (CPET). OBJECTIVES: The focus was to investigate the diagnostic accuracy of MPT to detect DH in a prospective and clinical study. METHODS: COPD patients were included; all underwent spirometry, CPET, and MPT. DH (ΔIC) was calculated as the difference in % between inspiratory capacity (IC) at the start and end of the test divided by IC at the start. A subject was identified as a hyperinflator, if ΔIC (% of ICrest) was smaller than -10.2 and -11.1% in CPET and MPT, respectively. With these values, sensitivity and specificity were calculated. Bland-Altman plots were made of ΔIC (% of ICrest). RESULTS: In the prospective and clinical study, 107 and 48 patients were included, respectively. Sensitivity of the MPT was 85% in both studies. The specificities were 33 and 27%, respectively. In the prospective study, B = +2.6%, L = 30.6, and -25.6%. In the clinical study, B = +0.8%, L = 31.0, and -29.1%. CONCLUSION: MPT seems to be a good replacement for CPET in group studies. The mean amount of DH was not different between CPET and MPT. On an individual level, MPT cannot be used to identify hyperinflators; it should be kept in mind that MPT overdiagnoses DH. The amount of DH should not be interchanged between CPET and MPT.
BACKGROUND: A simple technique to measure dynamic hyperinflation (DH) in patients with chronic obstructive pulmonary disease (COPD) is the metronome-paced tachypnea test (MPT). Earlier studies show conflicting results about the accuracy of the MPT compared to cardiopulmonary exercise testing (CPET). OBJECTIVES: The focus was to investigate the diagnostic accuracy of MPT to detect DH in a prospective and clinical study. METHODS:COPDpatients were included; all underwent spirometry, CPET, and MPT. DH (ΔIC) was calculated as the difference in % between inspiratory capacity (IC) at the start and end of the test divided by IC at the start. A subject was identified as a hyperinflator, if ΔIC (% of ICrest) was smaller than -10.2 and -11.1% in CPET and MPT, respectively. With these values, sensitivity and specificity were calculated. Bland-Altman plots were made of ΔIC (% of ICrest). RESULTS: In the prospective and clinical study, 107 and 48 patients were included, respectively. Sensitivity of the MPT was 85% in both studies. The specificities were 33 and 27%, respectively. In the prospective study, B = +2.6%, L = 30.6, and -25.6%. In the clinical study, B = +0.8%, L = 31.0, and -29.1%. CONCLUSION: MPT seems to be a good replacement for CPET in group studies. The mean amount of DH was not different between CPET and MPT. On an individual level, MPT cannot be used to identify hyperinflators; it should be kept in mind that MPT overdiagnoses DH. The amount of DH should not be interchanged between CPET and MPT.
Authors: Jorien Hannink; Anke Lahaije; Erik Bischoff; Hanneke van Helvoort; Richard Dekhuijzen; Tjard Schermer; Yvonne Heijdra Journal: Respir Med Date: 2010-05-10 Impact factor: 3.415
Authors: M R Miller; J Hankinson; V Brusasco; F Burgos; R Casaburi; A Coates; R Crapo; P Enright; C P M van der Grinten; P Gustafsson; R Jensen; D C Johnson; N MacIntyre; R McKay; D Navajas; O F Pedersen; R Pellegrino; G Viegi; J Wanger Journal: Eur Respir J Date: 2005-08 Impact factor: 16.671
Authors: Karin Klooster; Nick H T ten Hacken; Jorine E Hartman; Frank C Sciurba; Huib A M Kerstjens; Dirk-Jan Slebos Journal: Respiration Date: 2015-09-10 Impact factor: 3.580
Authors: Gregory L Calligaro; Richard I Raine; Mary E Bateman; Eric D Bateman; Christopher B Cooper Journal: COPD Date: 2013-10-23 Impact factor: 2.409
Authors: Anke J M C Lahaije; Laura M Willems; Hieronymus W H van Hees; P N Richard Dekhuijzen; Hanneke A C van Helvoort; Yvonne F Heijdra Journal: Clin Physiol Funct Imaging Date: 2012-09-02 Impact factor: 2.273
Authors: Klaus F Rabe; Suzanne Hurd; Antonio Anzueto; Peter J Barnes; Sonia A Buist; Peter Calverley; Yoshinosuke Fukuchi; Christine Jenkins; Roberto Rodriguez-Roisin; Chris van Weel; Jan Zielinski Journal: Am J Respir Crit Care Med Date: 2007-05-16 Impact factor: 21.405
Authors: Claus F Vogelmeier; Gerard J Criner; Fernando J Martinez; Antonio Anzueto; Peter J Barnes; Jean Bourbeau; Bartolome R Celli; Rongchang Chen; Marc Decramer; Leonardo M Fabbri; Peter Frith; David M G Halpin; M Victorina López Varela; Masaharu Nishimura; Nicolas Roche; Roberto Rodriguez-Roisin; Don D Sin; Dave Singh; Robert Stockley; Jørgen Vestbo; Jadwiga A Wedzicha; Alvar Agustí Journal: Am J Respir Crit Care Med Date: 2017-03-01 Impact factor: 21.405