Diagnostic accuracy of metronome‐paced tachypnea to detect dynamic hyperinflation

Lahaije, Anke; Willems, L.M.; Hees, Hieronymus W. H. van; Dekhuijzen, P.N.R.; Helvoort, H.A.C. van; Heijdra, Yvonne F.

doi:10.1111/j.1475-097x.2012.01164.x

Cited by 23 publications

(41 citation statements)

References 28 publications

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“…Compared to CPET, MPT has also been shown to induce more DH in some patients [4]. The fact that, with MPT, a nonphysiological breathing rhythm is imposed on patients might have contributed to the larger amount of DH compared to CPET-induced and ADL-induced DH.…”

Section: Discussionmentioning

confidence: 99%

“…In accordance with earlier studies [3,4], MPT was performed at twice the resting breathing frequency. Patients were asked to breathe at this pace for 20 s, immediately followed by a maximal inspiratory maneuver (IC MPT ).…”

Section: Methodsmentioning

confidence: 98%

“…This cut-off was based on the repeatability coefficient of measurements of IC [4]. A relative change in IC (ΔIC) was chosen over an absolute change, because absolute ΔIC is related to the IC value at rest, whereas relative ΔIC shows a more homoscedastic distribution [4,5,19,20]. …”

Section: Methodsmentioning

confidence: 99%

“…Commonly, DH is assessed through symptom-limited or constant workload cardiopulmonary exercise testing (CPET). For study purposes, DH has also been assessed with metronome-paced tachypnea (MPT), which has been shown to be a simple, reliable alternative to CPET when it comes to comparing DH between groups [3,4]. So far, it remains unknown whether the DH measured in laboratory settings, i.e.…”

Section: Introductionmentioning

confidence: 99%

“…In a previous study, we compared MPT-induced DH with CPET-induced DH [4]. It is likely that the amount of DH during ADL will be less than during CPET, as minute ventilation and breathing frequency are lower during submaximal activities [1], as seen in most ADL.…”

Section: Introductionmentioning

confidence: 99%

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Can COPD Patients Who Hyperinflate During Daily Life Activities Be Identified by Laboratory Tests?

Lahaije

Helvoort

Dekhuijzen³

et al. 2013

Respiration

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Background: Identification of patients with chronic obstructive pulmonary disease (COPD) who develop dynamic hyperinflation (DH) during activities in daily life (ADL) is important, because of the association between DH and dyspnea and exercise limitation. Objective: We aimed to answer the question whether measurements of DH during metronome-paced tachypnea (MPT) or cardiopulmonary exercise testing (CPET) can be used to identify patients who develop DH during ADL. Methods: DH was measured by tracking changes in inspiratory capacity during CPET, MPT and ADL. Bland-Altman plots were used to evaluate agreement in DH between methods. With a receiver operating characteristic (ROC) analysis, the overall accuracy of MPT and CPET to identify patients who hyperinflate during ADL was assessed. Results: There are broad limits of agreement in DH between methods. ROC curve analyses showed good overall accuracy of both CPET and MPT to identify patients who hyperinflate during ADL. For CPET, area under the curve (AUC) = 0.956 (95% CI 0.903-1.009). For MPT, AUC = 0.840 (95% CI 0.699-0.981). Sensitivity and specificity to identify patients who hyperinflate during ADL with CPET were 96 and 83%, respectively, and with MPT, they were 89 and 77%, respectively. Conclusion: Both CPET and MPT can serve as screening tools to identify patients who are susceptible to developing DH during ADL. In practice, MPT is the most simple and inexpensive surrogate. However, the sensitivity of MPT is not optimal. When DH does not occur during CPET, it is unlikely to occur during ADL.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Can COPD Patients Who Hyperinflate During Daily Life Activities Be Identified by Laboratory Tests?

Lahaije

Helvoort

Dekhuijzen³

et al. 2013

Respiration

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Dynamische hyperinflatie

Helvoort¹

2016

Praktische Handleiding Longfunctietesten

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Change in Dynamic Hyperinflation After Bronchoscopic Lung Volume Reduction in Patients with Emphysema

Dijk

Klooster

Hartman

et al. 2020

Lung

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Background and Purpose In patients with severe emphysema, dynamic hyperinflation is superimposed on top of already existing static hyperinflation. Static hyperinflation reduces significantly after bronchoscopic lung volume reduction (BLVR). In this study, we investigated the effect of BLVR compared to standard of care (SoC) on dynamic hyperinflation. Methods Dynamic hyperinflation was induced by a manually paced tachypnea test (MPT) and was defined by change in inspiratory capacity (IC) measured before and after MPT. Static and dynamic hyperinflation measurements were performed both at baseline and 6 months after BLVR with endobronchial valves or coils (treatment group) or SoC (control group). Results Eighteen patients underwent BLVR (78% female, 57 (43–67) years, FEV1 25(18–37) %predicted, residual volume 231 (182–376) %predicted). Thirteen patients received SoC (100% female, 59 (44–74) years, FEV1 25 (19–37) %predicted, residual volume 225 (152–279) %predicted. The 6 months median change in dynamic hyperinflation in the treatment group was: + 225 ml (range − 113 to + 803) (p < 0.01) vs 0 ml (− 1067 to + 500) in the control group (p = 0.422). An increase in dynamic hyperinflation was significantly associated with a decrease in residual volume (r = − 0.439, p < 0.01). Conclusion Bronchoscopic lung volume reduction increases the ability for dynamic hyperinflation in patients with severe emphysema. We propose this is a consequence of improved static hyperinflation.

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Diagnostic accuracy of metronome‐paced tachypnea to detect dynamic hyperinflation

Abstract: The MPT test shows good overall accuracy to identify subjects who are susceptible to develop dynamic hyperinflation during CPET. Before considering the use of MPT as a screening tool for dynamic hyperinflation in COPD, sensitivity and specificity need further evaluation.

Cited by 23 publications

References 28 publications

Can COPD Patients Who Hyperinflate During Daily Life Activities Be Identified by Laboratory Tests?

Can COPD Patients Who Hyperinflate During Daily Life Activities Be Identified by Laboratory Tests?

Dynamische hyperinflatie

Change in Dynamic Hyperinflation After Bronchoscopic Lung Volume Reduction in Patients with Emphysema

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