Eucapnic Voluntary Hyperpnea: Gold standard for diagnosing exercise-induced bronchoconstriction in athletes?

James Hull, Les Ansley, Ollie Price, John Dickinson, Matteo Bonini

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)
9 Downloads (Pure)

Abstract

In athletes, a secure diagnosis of exercise-induced bronchoconstriction (EIB) is dependent on objective testing. Evaluating spirometric indices of airflow before and following an exercise bout is intuitively the optimal means for the diagnosis; however, this approach is recognized as having several key limitations. Accordingly, alternative indirect bronchoprovocation tests have been recommended as surrogate means for obtaining a diagnosis of EIB. Of these tests, it is often argued that the eucapnic voluntary hyperpnea (EVH) challenge represents the ‘gold standard’. This article provides a state-of-the-art review of EVH, including an overview of the test methodology and its interpretation. We also address the performance of EVH against the other functional and clinical approaches commonly adopted for the diagnosis of EIB. The published evidence supports a key role for EVH in the diagnostic algorithm for EIB testing in athletes. However, its wide sensitivity and specificity and poor repeatability preclude EVH from being termed a ‘gold standard’ test for EIB.
Original languageEnglish
Pages (from-to)1083-1093
JournalSports Medicine
Volume46
Issue number8
Early online date23 Mar 2016
DOIs
Publication statusPublished - Aug 2016

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