Eucapnic voluntary hyperpnea challenge can support management of exercise-induced bronchoconstriction in elite swimmers

Introduction: This study investigated the use of eucapnic voluntary hyperpnea (EVH) to monitor efficacy of pharmacological therapy in elite swimmers with exercise-induced bronchoconstriction (EIB). Secondly, it evaluated the long-term test-retest repeatability of EVH in this population.

Methods: Twenty-seven elite international swimmers were included in this retrospective analysis of comprehensive respiratory assessments. Following an initial “withheld-therapy” assessment, athletes with EIB had been prescribed appropriate pharmacological therapy and returned twelve months later for a follow-up assessment to monitor EIB protection afforded by treatment. EIB-negative athletes had returned to confirm initial diagnosis, as were still reporting persistent respiratory symptoms. Athletes were retrospectively grouped into either “Therapy Adherent Group” (n = 12) or “Repeatability Group” (discontinued therapy at follow-up or EIB-negative, n = 15).

Results: Greatest fall in forced expiratory volume in 1 second (ΔFEV1max) was significantly lower following therapy adherence (−11.8 ± 3.8%) compared to initial assessment (−24.0 ± 11.3%; P < .01). “Repeatability Group” ΔFEV1max did not differ significantly between initial assessment (−13.1 ± 4.5%) and follow-up (−12.3 ± 5.6%; P = .32), and showed good agreement (0.6%; −5.9%, 7.1%).

Conclusion: A follow-up assessment utilizing EVH is useful in the management of EIB and shows good test-retest repeatability over twelve months in elite swimmers who discontinue treatment or are EIB-negative.