Document Detail

Exhaled nitric oxide as a predictor of exercise-induced bronchoconstriction.
MedLine Citation:
PMID:  12907554     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Exercise-induced bronchoconstriction (EIB) is present in 40 to 90% of patients with asthma. Exhaled NO (eNO) levels have been correlated with bronchial hyperresponsiveness to methacholine, and have correlated with the degree of decrease in FEV(1) with exercise. The purpose of our study was to examine whether eNO measurements prior to or after exercise could be used as a surrogate marker of exertional bronchoconstriction in a population referred specifically for the evaluation of EIB. METHODS: We studied 50 consecutive subjects without a history of asthma who were referred for the clinical evaluation of EIB. eNO levels were measured prior to exercise challenge and every 5 min for a total of 30 min after exercise. Forced expiratory flows were measured prior to and serially after exercise challenge. RESULTS: Seven subjects had a decrease in FEV(1) of > or = 15% with exercise. The mean eNO level prior to exercise was 41 parts per billion (ppb) [median +/- SD, 23 +/- 42.2 ppb] in the EIB group and 25.6 ppb (median, 19.95 +/- 18.47 ppb) in the group without EIB. A receiver operator characteristic curve yielded a value of 0.636. When using an eNO level of < 12 ppb, the sensitivity, specificity, negative predictive value, and positive predictive value for EIB were 1.0, 0.31, 0.19, and 1.0, respectively; therefore, no one with a baseline eNO of < 12 ppb demonstrated EIB. CONCLUSIONS: No subjects with very low pre-exercise eNO levels (< 12 ppb) demonstrated bronchial hyperresponsiveness to exercise. eNO measurement may obviate the need for bronchoprovocation testing in patients who complain of exertional dyspnea.
Samy M ElHalawani; Nam T Ly; Richard T Mahon; Dennis E Amundson
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Chest     Volume:  124     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-08     Completed Date:  2003-09-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  639-43     Citation Subset:  AIM; IM    
Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Naval Medical Center San Diego, San Diego, CA 92134, USA.
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MeSH Terms
Asthma, Exercise-Induced / diagnosis*,  metabolism
Biological Markers*
Exercise Test*
Nitric Oxide / metabolism*
Predictive Value of Tests
ROC Curve
Reg. No./Substance:
0/Biological Markers; 10102-43-9/Nitric Oxide

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