José Ângelo Rizzo1,2, Laienne Carla Barbosa de Barros Albuquerque2,3, Décio Medeiros1,2, Claudio Gonsalves de Albuquerque1,2, Edil de Albuquerque Rodrigues Filho1,2, Marcos André de Moura Santos3,4, Steve Hunter5, Nadia Gaua5, Marco Aurélio Valois de Correia Junior6,7,8. 1. Postgraduate Program in Child and Adolescent Health, Universidade Federal de Pernambuco, Recife, Brazil. 2. Center for Research in Allergy and Clinical Immunology, Hospital das Clínicas, Universidade Federal de Pernambuco, Rua Luiz Guimarães, 411, apto 301-a, CEP-52061-160, Poço da Panela, Recife, Brazil. 3. Postgraduate Program in Hebiatrics, Universidade de Pernambuco, Recife, Brazil. 4. Associated Postgraduate Program in Physical Education, Universidade de Pernambuco and Universidade Federal da Paraiba, Recife, Brazil. 5. Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, UK. 6. Center for Research in Allergy and Clinical Immunology, Hospital das Clínicas, Universidade Federal de Pernambuco, Rua Luiz Guimarães, 411, apto 301-a, CEP-52061-160, Poço da Panela, Recife, Brazil. marcovalois@gmail.com. 7. Postgraduate Program in Hebiatrics, Universidade de Pernambuco, Recife, Brazil. marcovalois@gmail.com. 8. Associated Postgraduate Program in Physical Education, Universidade de Pernambuco and Universidade Federal da Paraiba, Recife, Brazil. marcovalois@gmail.com.
Abstract
PURPOSE: Exercise-induced bronchoconstriction (EIB) affects approximately 50% of young asthma patients, impairing their participation in sports and physical activities. Eucapnic voluntary hyperpnea (EVH) is an approved surrogate challenge to exercise for objective EIB diagnosis, but the required minimum target hyperventilation rates remain unexplored in this population. This study aimed to evaluate the association between the achieved ventilation rates (VRs) during a challenge and EIB-compatible response (EIB-cr) in young asthma patients. METHODS: This cross-sectional study included 72 asthma patients aged 10-20 years. Forced expiratory volume in the first second (FEV1) was measured before and 5, 15, and 30 min after the EVH. The target VR was set at 21 times the individual's baseline FEV1. A decrease of > 10% in FEV1 after the challenge was considered an EIB-cr. The challenge was repeated after 48-72 h in those without an EIB-cr. RESULTS: Thirty-six individuals had an EIB-cr at initial evaluation. The median VRs achieved was not different between individuals with and without an EIB-cr (19.8 versus 17.9; p = 0.619). The proportion of individuals with an EIB-cr was nor different comparing those who achieved (12/25) or not (24/47) the calculated target VRs (p = 0.804). At the repeated EVH challenge an EIB-cr was observed in 14/36 individuals with a negative response in the first evaluation, with no differences in achieved VRs between the two tests (p = 0.463). CONCLUSION: Irrespective of the achieved VR, an EIB-compatible response after an EVH challenge must be considered relevant for clinical and therapeutic judgment and negative tests should be repeated.
PURPOSE: Exercise-induced bronchoconstriction (EIB) affects approximately 50% of young asthma patients, impairing their participation in sports and physical activities. Eucapnic voluntary hyperpnea (EVH) is an approved surrogate challenge to exercise for objective EIB diagnosis, but the required minimum target hyperventilation rates remain unexplored in this population. This study aimed to evaluate the association between the achieved ventilation rates (VRs) during a challenge and EIB-compatible response (EIB-cr) in young asthma patients. METHODS: This cross-sectional study included 72 asthma patients aged 10-20 years. Forced expiratory volume in the first second (FEV1) was measured before and 5, 15, and 30 min after the EVH. The target VR was set at 21 times the individual's baseline FEV1. A decrease of > 10% in FEV1 after the challenge was considered an EIB-cr. The challenge was repeated after 48-72 h in those without an EIB-cr. RESULTS: Thirty-six individuals had an EIB-cr at initial evaluation. The median VRs achieved was not different between individuals with and without an EIB-cr (19.8 versus 17.9; p = 0.619). The proportion of individuals with an EIB-cr was nor different comparing those who achieved (12/25) or not (24/47) the calculated target VRs (p = 0.804). At the repeated EVH challenge an EIB-cr was observed in 14/36 individuals with a negative response in the first evaluation, with no differences in achieved VRs between the two tests (p = 0.463). CONCLUSION: Irrespective of the achieved VR, an EIB-compatible response after an EVH challenge must be considered relevant for clinical and therapeutic judgment and negative tests should be repeated.
Authors: John M Weiler; Sandra D Anderson; Christopher Randolph; Sergio Bonini; Timothy J Craig; David S Pearlman; Kenneth W Rundell; William S Silvers; William W Storms; David I Bernstein; Joann Blessing-Moore; Linda Cox; David A Khan; David M Lang; Richard A Nicklas; John Oppenheimer; Jay M Portnoy; Diane E Schuller; Sheldon L Spector; Stephen A Tilles; Dana Wallace; William Henderson; Lawrence Schwartz; David Kaufman; Talal Nsouli; Lawrence Shieken; Nelson Rosario Journal: Ann Allergy Asthma Immunol Date: 2010-12 Impact factor: 6.347
Authors: Jonathan P Parsons; David Cosmar; Gary Phillips; Christopher Kaeding; Thomas M Best; John G Mastronarde Journal: J Asthma Date: 2012-01-25 Impact factor: 2.515
Authors: Jonathan P Parsons; Teal S Hallstrand; John G Mastronarde; David A Kaminsky; Kenneth W Rundell; James H Hull; William W Storms; John M Weiler; Fern M Cheek; Kevin C Wilson; Sandra D Anderson Journal: Am J Respir Crit Care Med Date: 2013-05-01 Impact factor: 21.405
Authors: Klaus F Rabe; Mitsuru Adachi; Christopher K W Lai; Joan B Soriano; Paul A Vermeire; Kevin B Weiss; Scott T Weiss Journal: J Allergy Clin Immunol Date: 2004-07 Impact factor: 10.793
Authors: Carol A Mancuso; Wendy Sayles; Laura Robbins; Erica G Phillips; Karima Ravenell; Christine Duffy; Suzanne Wenderoth; Mary E Charlson Journal: J Asthma Date: 2006-03 Impact factor: 2.515
Authors: Teal S Hallstrand; J Randall Curtis; Thomas D Koepsell; Diane P Martin; Robert B Schoene; Sean D Sullivan; Gerald N Yorioka; Moira L Aitken Journal: J Pediatr Date: 2002-09 Impact factor: 4.406