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Provocation by eucapnic voluntary hyperpnoea to identify exercise induced bronchoconstriction
S D Anderson1, G J Argyros, H Magnussen
1Department of Respiratory Medicine, Level 9 Page Chest Pavilion, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia. sandya@mail.med.usyd.edu.au
British Journal of Sports Medicine
|October 2, 2001
Summary
The International Olympic Committee Medical Commission (IOC-MC) now requires athletes to provide evidence for beta(2) agonist use. Eucapnic voluntary hyperpnoea (EVH) is the recommended test to diagnose exercise-induced bronchoconstriction (EIB).
Area of Science:
- Sports Medicine
- Pulmonary Physiology
- Anti-Doping Regulations
Background:
- The International Olympic Committee Medical Commission (IOC-MC) mandates notification for beta(2) agonist use during the Winter Olympic Games.
- This notification requires objective evidence justifying the need for medication seven days prior to the event.
Purpose of the Study:
- To outline the IOC-MC's stance on beta(2) agonist use in elite athletes.
- To present eucapnic voluntary hyperpnoea (EVH) as the optimal laboratory method for diagnosing exercise-induced bronchoconstriction (EIB).
Main Methods:
- The study describes the eucapnic voluntary hyperpnoea (EVH) test, a specific challenge test designed to identify EIB.
- The EVH test involves subjects hyperventilating dry air with 5% carbon dioxide for six minutes.
- Ventilation is targeted at 30 times the subject's forced expiratory volume in one second (FEV(1)), with conditions adjustable to mimic athlete-specific triggers.
Main Results:
- A positive test for EIB is defined as a 10% or greater reduction in FEV(1) compared to pre-test values.
- EVH has a proven track record, having been successfully performed in thousands of subjects in both laboratory and field settings.
Conclusions:
- Eucapnic voluntary hyperpnoea (EVH) is currently considered the gold standard for confirming exercise-induced bronchoconstriction (EIB) in athletes.
- The IOC-MC utilizes EVH results to validate the necessity of beta(2) agonist use in competitive sports.
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