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Ventilation Rates Achieved in Eucapnic Voluntary Hyperpnea Challenge and Exercise-Induced Bronchoconstriction Diagnosis in Young Patients with Asthma

  • EXERCISE-INDUCED BRONCHOCONSTRICTION
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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.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Postgraduate Program in Child and Adolescent Health, Universidade Federal de Pernambuco, Recife, Brazil

    José Ângelo Rizzo, Décio Medeiros, Claudio Gonsalves de Albuquerque & Edil de Albuquerque Rodrigues Filho

  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

    José Ângelo Rizzo, Laienne Carla Barbosa de Barros Albuquerque, Décio Medeiros, Claudio Gonsalves de Albuquerque, Edil de Albuquerque Rodrigues Filho & Marco Aurélio Valois de Correia Junior

  3. Postgraduate Program in Hebiatrics, Universidade de Pernambuco, Recife, Brazil

    Laienne Carla Barbosa de Barros Albuquerque, Marcos André de Moura Santos & Marco Aurélio Valois de Correia Junior

  4. Associated Postgraduate Program in Physical Education, Universidade de Pernambuco and Universidade Federal da Paraiba, Recife, Brazil

    Marcos André de Moura Santos & Marco Aurélio Valois de Correia Junior

  5. Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, UK

    Steve Hunter & Nadia Gaua

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  1. José Ângelo Rizzo
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  2. Laienne Carla Barbosa de Barros Albuquerque
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  9. Marco Aurélio Valois de Correia Junior
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Contributions

LCBdeBA, CGdeA, and ERF contributed to data collection, analysis, conception, and design. JÂR, DM, MAMdosS, SH, NG, and MAVdeCJ contributed to conception, design, and interpretation of the data, the drafting of the paper, or revising it critically for intellectual content; and the final approval of the version to be published. All authors agree to be accountable for all aspects of the work related to its accuracy or integrity and all authors read and approved the final manuscript.

Corresponding author

Correspondence to Marco Aurélio Valois de Correia Junior.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University B (Date. 2019/No.: 2.796.049).

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All parents and adolescents signed an informed consent form.

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Rizzo, J.Â., de Barros Albuquerque, L.C.B., Medeiros, D. et al. Ventilation Rates Achieved in Eucapnic Voluntary Hyperpnea Challenge and Exercise-Induced Bronchoconstriction Diagnosis in Young Patients with Asthma. Lung 200, 229–236 (2022). https://doi.org/10.1007/s00408-022-00519-0

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