Clinical role of rapid-incremental tests in the evaluation of exercise-induced bronchoconstriction
Main Author: | |
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Publication Date: | 2005 |
Other Authors: | , , , , |
Format: | Article |
Language: | eng |
Source: | Repositório Institucional da UNIFESP |
Download full: | http://repositorio.unifesp.br/handle/11600/28483 http://dx.doi.org/10.1378/chest.128.4.2435 |
Summary: | Study objective: To determine whether rapid-incremental work rate (IWR) testing would be as useful as standard high-intensity constant work rate (CWR) protocols in eliciting exercise-induced bronchoconstriction (EIB) in susceptible subjects.Design and setting: A cross-sectional study performed in a clinical laboratory of a tertiary, university-based center.Subjects and measurements: Fifty-eight subjects (32 males, age range, 9 to 45 years) with suspected EM were submitted to CWR testing (American Thoracic Society/European Respiratory Society guidelines) and IWR testing on different days; 21 subjects repeated both tests within 4 weeks. Spirometric measurements were obtained 5, 10, 15, and 20 min after exercise; a FEV1 decline > 10% defined EIB.Results: Twenty-seven subjects presented with EM either after CWR or IWR testing; 21 subjects had EIB in response to both protocols (kappa = 0.78, excellent agreement; p < 0.001). of the six subjects in whom discordant results were found, two had EM only after IWR. Assuming CWR as the criterion test, IWR combined high positive and negative predictive values for EM detection (91.3% and 88.6%, respectively). Tests reproducibility in eliciting EIB were similar (kappa = 0.80 and 0.72 for CWR and IWR, respectively; p < 0.001). Total and intense (minute ventilation > 40% of maximum voluntary, ventilation) ventilatory stresses did not differ between EM-positive and EIB-negative subjects, independent of the test format. There were no significant bet-ween-test differences on FEV1 decline in EIB-positive subjects (25.7 +/- 10.8% vs 23.7 +/- 10.0%, respectively; p > 0.05). Therefore, no correlation was found between exercise ventilatory response and the magnitude of EM after either test (p > 0.05).Conclusions: Rapid-incremental protocols (8 to 12 min in duration) can be as useful as high-intensity CWR tests in diagnosing EM in susceptible subjects. Postexercise spirometry should be performed after incremental cardiopulmonary exercise testing when EM is clinically suspected. |
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De Fuccio, Marcelo B. [UNIFESP]Nery, Luiz E. [UNIFESP]Malaguti, Carla [UNIFESP]Taguchi, SabrinaDal Corso, Simonel [UNIFESP]Neder, Jose Alberto [UNIFESP]Universidade Federal de São Paulo (UNIFESP)2016-01-24T12:38:05Z2016-01-24T12:38:05Z2005-10-01Chest. Northbrook: Amer Coll Chest Physicians, v. 128, n. 4, p. 2435-2442, 2005.0012-3692http://repositorio.unifesp.br/handle/11600/28483http://dx.doi.org/10.1378/chest.128.4.243510.1378/chest.128.4.2435WOS:000232679400078Study objective: To determine whether rapid-incremental work rate (IWR) testing would be as useful as standard high-intensity constant work rate (CWR) protocols in eliciting exercise-induced bronchoconstriction (EIB) in susceptible subjects.Design and setting: A cross-sectional study performed in a clinical laboratory of a tertiary, university-based center.Subjects and measurements: Fifty-eight subjects (32 males, age range, 9 to 45 years) with suspected EM were submitted to CWR testing (American Thoracic Society/European Respiratory Society guidelines) and IWR testing on different days; 21 subjects repeated both tests within 4 weeks. Spirometric measurements were obtained 5, 10, 15, and 20 min after exercise; a FEV1 decline > 10% defined EIB.Results: Twenty-seven subjects presented with EM either after CWR or IWR testing; 21 subjects had EIB in response to both protocols (kappa = 0.78, excellent agreement; p < 0.001). of the six subjects in whom discordant results were found, two had EM only after IWR. Assuming CWR as the criterion test, IWR combined high positive and negative predictive values for EM detection (91.3% and 88.6%, respectively). Tests reproducibility in eliciting EIB were similar (kappa = 0.80 and 0.72 for CWR and IWR, respectively; p < 0.001). Total and intense (minute ventilation > 40% of maximum voluntary, ventilation) ventilatory stresses did not differ between EM-positive and EIB-negative subjects, independent of the test format. There were no significant bet-ween-test differences on FEV1 decline in EIB-positive subjects (25.7 +/- 10.8% vs 23.7 +/- 10.0%, respectively; p > 0.05). Therefore, no correlation was found between exercise ventilatory response and the magnitude of EM after either test (p > 0.05).Conclusions: Rapid-incremental protocols (8 to 12 min in duration) can be as useful as high-intensity CWR tests in diagnosing EM in susceptible subjects. Postexercise spirometry should be performed after incremental cardiopulmonary exercise testing when EM is clinically suspected.Universidade Federal de São Paulo, Div Resp Dis, Pulm Funct & Clin Exercise Physiol Unit, BR-04020050 São Paulo, BrazilUniversidade Federal de São Paulo, Div Resp Dis, Pulm Funct & Clin Exercise Physiol Unit, BR-04020050 São Paulo, BrazilWeb of Science2435-2442engAmer Coll Chest PhysiciansChestasthmabronchoprovocationexercise-induced asthmaexercise testsClinical role of rapid-incremental tests in the evaluation of exercise-induced bronchoconstrictioninfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP11600/284832022-02-18 12:05:31.582metadata only accessoai:repositorio.unifesp.br:11600/28483Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-05-25T12:08:28.499946Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Clinical role of rapid-incremental tests in the evaluation of exercise-induced bronchoconstriction |
title |
Clinical role of rapid-incremental tests in the evaluation of exercise-induced bronchoconstriction |
spellingShingle |
Clinical role of rapid-incremental tests in the evaluation of exercise-induced bronchoconstriction De Fuccio, Marcelo B. [UNIFESP] asthma bronchoprovocation exercise-induced asthma exercise tests |
title_short |
Clinical role of rapid-incremental tests in the evaluation of exercise-induced bronchoconstriction |
title_full |
Clinical role of rapid-incremental tests in the evaluation of exercise-induced bronchoconstriction |
title_fullStr |
Clinical role of rapid-incremental tests in the evaluation of exercise-induced bronchoconstriction |
title_full_unstemmed |
Clinical role of rapid-incremental tests in the evaluation of exercise-induced bronchoconstriction |
title_sort |
Clinical role of rapid-incremental tests in the evaluation of exercise-induced bronchoconstriction |
author |
De Fuccio, Marcelo B. [UNIFESP] |
author_facet |
De Fuccio, Marcelo B. [UNIFESP] Nery, Luiz E. [UNIFESP] Malaguti, Carla [UNIFESP] Taguchi, Sabrina Dal Corso, Simonel [UNIFESP] Neder, Jose Alberto [UNIFESP] |
author_role |
author |
author2 |
Nery, Luiz E. [UNIFESP] Malaguti, Carla [UNIFESP] Taguchi, Sabrina Dal Corso, Simonel [UNIFESP] Neder, Jose Alberto [UNIFESP] |
author2_role |
author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
De Fuccio, Marcelo B. [UNIFESP] Nery, Luiz E. [UNIFESP] Malaguti, Carla [UNIFESP] Taguchi, Sabrina Dal Corso, Simonel [UNIFESP] Neder, Jose Alberto [UNIFESP] |
dc.subject.eng.fl_str_mv |
asthma bronchoprovocation exercise-induced asthma exercise tests |
topic |
asthma bronchoprovocation exercise-induced asthma exercise tests |
description |
Study objective: To determine whether rapid-incremental work rate (IWR) testing would be as useful as standard high-intensity constant work rate (CWR) protocols in eliciting exercise-induced bronchoconstriction (EIB) in susceptible subjects.Design and setting: A cross-sectional study performed in a clinical laboratory of a tertiary, university-based center.Subjects and measurements: Fifty-eight subjects (32 males, age range, 9 to 45 years) with suspected EM were submitted to CWR testing (American Thoracic Society/European Respiratory Society guidelines) and IWR testing on different days; 21 subjects repeated both tests within 4 weeks. Spirometric measurements were obtained 5, 10, 15, and 20 min after exercise; a FEV1 decline > 10% defined EIB.Results: Twenty-seven subjects presented with EM either after CWR or IWR testing; 21 subjects had EIB in response to both protocols (kappa = 0.78, excellent agreement; p < 0.001). of the six subjects in whom discordant results were found, two had EM only after IWR. Assuming CWR as the criterion test, IWR combined high positive and negative predictive values for EM detection (91.3% and 88.6%, respectively). Tests reproducibility in eliciting EIB were similar (kappa = 0.80 and 0.72 for CWR and IWR, respectively; p < 0.001). Total and intense (minute ventilation > 40% of maximum voluntary, ventilation) ventilatory stresses did not differ between EM-positive and EIB-negative subjects, independent of the test format. There were no significant bet-ween-test differences on FEV1 decline in EIB-positive subjects (25.7 +/- 10.8% vs 23.7 +/- 10.0%, respectively; p > 0.05). Therefore, no correlation was found between exercise ventilatory response and the magnitude of EM after either test (p > 0.05).Conclusions: Rapid-incremental protocols (8 to 12 min in duration) can be as useful as high-intensity CWR tests in diagnosing EM in susceptible subjects. Postexercise spirometry should be performed after incremental cardiopulmonary exercise testing when EM is clinically suspected. |
publishDate |
2005 |
dc.date.issued.fl_str_mv |
2005-10-01 |
dc.date.accessioned.fl_str_mv |
2016-01-24T12:38:05Z |
dc.date.available.fl_str_mv |
2016-01-24T12:38:05Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Chest. Northbrook: Amer Coll Chest Physicians, v. 128, n. 4, p. 2435-2442, 2005. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/28483 http://dx.doi.org/10.1378/chest.128.4.2435 |
dc.identifier.issn.none.fl_str_mv |
0012-3692 |
dc.identifier.doi.none.fl_str_mv |
10.1378/chest.128.4.2435 |
dc.identifier.wos.none.fl_str_mv |
WOS:000232679400078 |
identifier_str_mv |
Chest. Northbrook: Amer Coll Chest Physicians, v. 128, n. 4, p. 2435-2442, 2005. 0012-3692 10.1378/chest.128.4.2435 WOS:000232679400078 |
url |
http://repositorio.unifesp.br/handle/11600/28483 http://dx.doi.org/10.1378/chest.128.4.2435 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Chest |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
2435-2442 |
dc.publisher.none.fl_str_mv |
Amer Coll Chest Physicians |
publisher.none.fl_str_mv |
Amer Coll Chest Physicians |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
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1783460254881677312 |