Abstract
Exercise-induced bronchoconstriction (EIBc) is a recognised response to exercise in asthmatic subjects and athletes but is less well understood in an unselected broad population. Exercise-induced bronchodilation (EIBd) has received even less attention. The objective of this study was to investigate the effects of age, sex, forced expiratory volume in 1 s (FEV1) and airflow limitation (FEV1/forced vital capacity (FVC) <0.7) on the prevalence of EIBc and EIBd.
This was a retrospective study based on incremental cardiopulmonary exercise testing on cycle ergometry to symptom limitation performed between 1988 and 2012. FEV1 was measured before and 10 min after exercise. EIBc was defined as a percentage fall in FEV1 post-exercise below the 5th percentile, while EIBd was defined as a percentage increase in FEV1 above the 95th percentile.
35 258 subjects aged 6–95 years were included in the study (mean age 53 years, 60% male) and 10.3% had airflow limitation (FEV1/FVC <0.7). The lowest 5% of subjects demonstrated a ≥7.6% fall in FEV1 post-exercise (EIBc), while the highest 5% demonstrated a >11% increase in FEV1 post-exercise (EIBd). The probability of both EIBc and EIBd increased with age and was highest in females across all ages (OR 1.76, 95% CI 1.60–1.94; p<0.0001). The probability of EIBc increased as FEV1 % pred declined (<40%: OR 4.38, 95% CI 3.04–6.31; p<0.0001), with a >2-fold increased likelihood in females (OR 2.31, 95% CI 1.71–3.11; p<0.0001), with a trend with airflow limitation (p=0.06). The probability of EIBd increased as FEV1 % pred declined, in the presence of airflow limitation (OR 1.55, 95% CI 1.24–1.95; p=0.0001), but sex had no effect.
EIBc and EIBd can be demonstrated at the population level, and are influenced by age, sex, FEV1 % pred and airflow limitation.
Abstract
Exercise-induced bronchoconstriction (EIBc) and bronchodilation (EIBd) occur after exercise, and are influenced by increasing age, lower FEV1 % pred and airflow limitation. Female sex influences EIBc but not EIBd. https://bit.ly/3nDGrwm
Footnotes
Author contributions: All authors conceptualised and designed the study, had full access to all the data, and contributed to data analysis, interpretation and writing of the manuscript.
Conflict of interest: I. Satia reports personal fees for lectures from GSK and AstraZeneca, grants and personal fees from Merck Canada, grants from ERS Respire 3 Marie Curie Fellowship, outside the submitted work.
Conflict of interest: E. Priel has nothing to disclose.
Conflict of interest: B.K. Al-Khazraji has nothing to disclose.
Conflict of interest: G. Jones has nothing to disclose.
Conflict of interest: A. Freitag has nothing to disclose.
Conflict of interest: P.M. O'Byrne reports grants and personal fees from AstraZeneca and Medimmune, grants from Novartis, personal fees from GSK and Chiesi, outside the submitted work.
Conflict of interest: K.J. Killian has nothing to disclose.
- Received October 30, 2020.
- Accepted January 5, 2021.
- Copyright ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org