The Clinical Utility of Eucapnic Voluntary Hyperventilation Testing for the Diagnosis of Exercise-Induced Bronchospasm

Abstract

We present the first description of the clinical use of EVH testing for the diagnosis of EIB in a large pulmonary practice. EVH was diagnostic in a large majority of patients. EVH is an excellent and feasible modality to diagnose EIB in patients seen in a general pulmonary practice. Our data highlight the need for further studies regarding the appropriate minimum threshold minute ventilation for an EVH test and to explain potential mechanisms for seemingly different stimulus thresholds for bronchospasm in males versus females.

Exercise-induced bronchoconstriction diagnosis in asthmatic children: comparison of treadmill running and eucapnic voluntary hyperventilation challenges

“…3,6e8 However, although well standardized, 5 the clinical usefulness of EVH for the diagnosis of EIB in children and adolescents with asthma has not been established. 9 Thus, the aim of this study was to compare TR with EVH as a bronchial challenge for EIB diagnosis in this patient group.…”

Reproducibility of the bronchoconstrictive response to eucapnic voluntary hyperpnoea

“…39,40 Women are also 2.38 times less likely than males to achieve a ̇ of 60% MVV during EVH (a criterion for an adequate test), although they may also experience bronchoconstriction at a lower ̇ than men. 41 These confounders may influence the ability of the EVH test to elicit a reproducible fall in FEV 1 in women with asthma. Further studies are therefore needed to establish the utility of the EVH test in women with asthma, including whether a reproducible bronchoconstrictive response is elicited across different time intervals and phases of the menstrual cycle.…”

Alternatives to exercise challenge for the objective assessment of exercise-induced bronchospasm: eucapnic voluntary hyperpnoea and the osmotic challenge tests

“…For most subjects not competing at elite level, a ventilation exceeding 21 times the FEV1 (60% MVV) is likely to be close to the maximum ventilation achieved during exercise in a test for EIB [19]. In a pulmonary function laboratory setting, 81% of the patients referred for testing for EIB were able to achieve this target [20]. The minimum level for a valid test may be set as low as 17.5 times the FEV1 for 6 min to be consistent with exercise ventilation [19].…”