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Mid-expiratory flow versus FEV1 measurements in the diagnosis of exercise induced asthma in elite athletes.

Dickinson, John W., Whyte, G.P., McConnell, A.K., Nevill, A.M., Harries, M.G. (2006) Mid-expiratory flow versus FEV1 measurements in the diagnosis of exercise induced asthma in elite athletes. Thorax, 61 (2). pp. 111-114. ISSN 0040-6376. (doi:10.1136/thx.2005.046615) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:43907)

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Official URL
http://dx.doi.org/10.1136/thx.2005.046615

Abstract

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.

Item Type: Article
DOI/Identification number: 10.1136/thx.2005.046615
Subjects: R Medicine > RC Internal medicine > RC1200 Sports medicine
Divisions: Divisions > Division of Natural Sciences > School of Sport and Exercise Sciences
Depositing User: John Dickinson
Date Deposited: 27 Nov 2014 12:44 UTC
Last Modified: 16 Feb 2021 12:56 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/43907 (The current URI for this page, for reference purposes)
Dickinson, John W.: https://orcid.org/0000-0002-1824-7402
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