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Pulmonary Function Tests (PFTs)
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Eucapnic Voluntary Hyperventilation to Detect Exercise-Induced Bronchoconstriction in Cystic Fibrosis.

Stephen E Kirkby1,2, Don Hayes3,4, Jonathan P Parsons4

  • 1Section of Pulmonary Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. stephen.kirkby@nationwidechildrens.org.

Lung
|June 4, 2015
PubMed
Summary

Eucapnic voluntary hyperventilation (EVH) testing is a safe and effective way to diagnose exercise-induced bronchoconstriction (EIB) in cystic fibrosis (CF) patients with good lung function. EVH may be more sensitive than exercise challenges for detecting EIB.

Keywords:
Cardiopulmonary exercise testingCystic fibrosisEucapnic voluntary hyperventilationExercise-induced bronchoconstriction

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Area of Science:

  • Pulmonary Medicine
  • Pediatric Pulmonology
  • Exercise Physiology

Background:

  • Exercise-induced bronchoconstriction (EIB) is not well-understood in cystic fibrosis (CF).
  • Eucapnic voluntary hyperventilation (EVH) testing has not been previously utilized for EIB assessment in CF.
  • Objective assessment of EIB in CF patients with preserved lung function requires further investigation.

Purpose of the Study:

  • To evaluate the safety and effectiveness of EVH testing for diagnosing EIB in CF patients.
  • To compare EVH testing with cardiopulmonary exercise testing (CPET) for EIB detection in CF.
  • To establish EVH as a potential objective diagnostic tool for EIB in CF.

Main Methods:

  • A prospective pilot study involving 10 CF patients with forced expiratory volume in 1 second (FEV1) ≥70% predicted.
  • Standard EVH testing was performed on all participants.
  • Cardiopulmonary exercise testing (CPET) with pre- and post-exercise spirometry served as a comparative assessment.

Main Results:

  • EVH testing demonstrated a 20% (2/10) diagnosis rate for EIB.
  • Both patients diagnosed with EIB via EVH reported consistent clinical symptoms.
  • No patients met the criteria for EIB based on CPET results, suggesting EVH may be more sensitive.

Conclusions:

  • EVH testing is a safe and effective method for objectively assessing EIB in CF patients with well-preserved lung function.
  • EVH testing may offer greater sensitivity in detecting EIB compared to standard exercise challenge tests.
  • This study supports the use of EVH as a valuable diagnostic tool for EIB in specific CF populations.