An evaluation of standardizing target ventilation for eucapnic voluntary hyperventilation using FEV1

Area of Science:

• Sports Medicine
• Pulmonary Physiology
• Exercise Science

Background:

• Athletes require objective documentation of exercise-induced bronchoconstriction (EIB) for Olympic competition using beta2-agonists.
• Eucapnic voluntary hyperventilation (EVH) with a target ventilation (TV) of 30 times forced expiratory volume in the first second (FEV1) is a standard diagnostic method.
• The accuracy of predicting maximal voluntary ventilation (MVV) from FEV1 in elite athletes is not well-established.

Purpose of the Study:

• To evaluate the efficacy of using 30 x FEV1 as a standardized EVH TV in elite athletes.
• To determine if this method accurately reflects 85% of maximal voluntary ventilation (MVV).

Main Methods:

• Retrospective analysis of pulmonary function and maximal minute ventilation during exercise (VEmax) in 78 elite winter athletes.
• Assessment of the ratio between EVH TV (30 x FEV1) and VEmax to ascertain adequacy and variability.
• Comparison of VEmax to predicted MVV (35 x FEV1).

Main Results:

• VEmax averaged 99% of predicted MVV (35 x FEV1) and was strongly correlated (r=0.85).
• The calculated EVH TV (30 x FEV1) represented 88% of VEmax, with significant variability (range: 64-109%).
• The 30 x FEV1 method may lead to under-diagnosis of EIB in some elite athletes due to high variability.

Conclusions:

• The 30 x FEV1 method for setting EVH TV exhibits high variability in elite athletes, potentially causing under-diagnosis.
• Recommending 85% of measured maximal minute ventilation (VEmax) as a more accurate and reliable EVH TV for elite athletes.
• If VEmax is unavailable, 85% of measured MVV is a viable alternative for establishing EVH TV.