title: Eucapnic Voluntary Hyperpnea: Gold Standard for Diagnosing Exercise-Induced Bronchoconstriction in Athletes?
abstract: In athletes, a secure diagnos is 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.
authors.affiliation: Department of Respiratory Medicine, Royal Brompton Hospital, London, UK.|National Heart and Lung Institute, Imperial College London, London, UK.
authors.forename: James H
authors.initials: JH
authors.lastname: Hull
authors.affiliation: Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
authors.forename: Les
authors.initials: L
authors.lastname: Ansley
authors.affiliation: Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, UK. o.price@leedsbeckett.ac.uk.
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Price
authors.affiliation: Sports Therapy, Physical Activity and Health Research Group, School of Sport and Exercise Sciences, University of Kent, Chatham Maritime, UK.
authors.forename: John W
authors.initials: JW
authors.lastname: Dickinson
authors.affiliation: National Heart and Lung Institute, Imperial College London, London, UK.|Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bonini
mesh_terms: D001250:Asthma, Exercise-Induced / Q000175:diagnosis* / Q000503:physiopathology; D016084:Bronchoconstriction / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005541:Forced Expiratory Volume; D006801:Humans; D006985:Hyperventilation / Q000503:physiopathology