Document Detail

Mid-expiratory flow versus FEV1 measurements in the diagnosis of exercise induced asthma in elite athletes.
MedLine Citation:
PMID:  16227323     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A fall in FEV(1) of > or =10% following bronchoprovocation (eucapnic voluntary hyperventilation (EVH) or exercise) is regarded as the gold standard criterion for diagnosing exercise induced asthma (EIA) in athletes. Previous studies have suggested that mid-expiratory flow (FEF(50)) might be used to supplement FEV(1) to improve the sensitivity and specificity of the diagnosis. A study was undertaken to investigate the response of FEF(50) following EVH or exercise challenges in elite athletes as an adjunct to FEV(1).
METHODS: Sixty six male (36 asthmatic, 30 non-asthmatic) and 50 female (24 asthmatic, 26 non-asthmatic) elite athletes volunteered for the study. Maximal voluntary flow-volume loops were measured before and 3, 5, 10, and 15 minutes after stopping EVH or exercise. A fall in FEV(1) of > or =10% and a fall in FEF(50) of > or =26% were used as the cut off criteria for identification of EIA.
RESULTS: There was a strong correlation between DeltaFEV(1) and DeltaFEF(50) following bronchoprovocation (r = 0.94, p = 0.000). Sixty athletes had a fall in FEV(1) of > or =10% leading to the diagnosis of EIA. Using the FEF(50) criterion alone led to 21 (35%) of these asthmatic athletes receiving a false negative diagnosis. The lowest fall in FEF(50) in an athlete with a > or =10% fall in FEV(1) was 14.3%. Reducing the FEF(50) criteria to > or =14% led to 13 athletes receiving a false positive diagnosis. Only one athlete had a fall in FEF(50) of > or =26% in the absence of a fall in FEV(1) of > or =10% (DeltaFEV(1) = 8.9%).
CONCLUSION: The inclusion of FEF(50) in the diagnosis of EIA in elite athletes reduces the sensitivity and does not enhance the sensitivity or specificity of the diagnosis. The use of FEF(50) alone is insufficiently sensitive to diagnose EIA reliably in elite athletes.
J W Dickinson; G P Whyte; A K McConnell; A M Nevill; M G Harries
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-10-14
Journal Detail:
Title:  Thorax     Volume:  61     ISSN:  0040-6376     ISO Abbreviation:  Thorax     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-30     Completed Date:  2006-02-14     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  111-4     Citation Subset:  IM    
English Institute of Sport, Bisham Abbey High, Performance Centre, Bisham, Nr Marlow, Bucks SL7 1RT, UK.
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MeSH Terms
Asthma, Exercise-Induced / diagnosis*,  physiopathology
Bronchial Provocation Tests / methods
Bronchoconstriction / physiology
Forced Expiratory Volume / physiology
Sensitivity and Specificity
Sports / physiology*
Vital Capacity / physiology
Comment In:
Thorax. 2006 Feb;61(2):94-6   [PMID:  16443702 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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