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Original Research: Asthma |

Perception of Bronchoconstriction Following Methacholine and Eucapnic Voluntary Hyperpnea Challenges in Elite AthletesPerception of Bronchoconstriction in Athletes

Simon Couillard, BSc; Valérie Bougault, PhD; Julie Turmel, PhD; Louis-Philippe Boulet, MD, FCCP
Author and Funding Information

From the Centre de Recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec (Mr Couillard and Drs Turmel and Boulet), Québec City, QC, Canada; and Université du Droit et de la Santé (Dr Bougault), Faculté des Sciences du Sport et de l’Éducation physique, Ronchin, France.

Correspondence to: Louis-Philippe Boulet, MD, FCCP, Institut universitaire de cardiologie et de pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec City, QC, G1V 4G5, Canada; e-mail: lpboulet@med.ulaval.ca


Funding/Support: This study was supported by local funds from Louis-Philippe Boulet.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(4):794-802. doi:10.1378/chest.13-1413
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Published online

Objective:  Self-reported respiratory symptoms are poor predictors of exercise-induced bronchoconstriction (EIB) in athletes. The objective of this study was to determine whether athletes have an inadequate perception of bronchoconstriction.

Methods:  One hundred thirty athletes and 32 nonathletes completed a standardized questionnaire and underwent eucapnic voluntary hyperpnea (EVH) and methacholine inhalation test. Perception scores were quoted on a modified Borg scale before each spirometry measurement for cough, breathlessness, chest tightness, and wheezing. Perception slope values were also obtained by plotting the variation of perception scores before and after the challenges against the fall in FEV1 expressed as a percentage of the initial value [(perception scores after − before)/FEV1].

Results:  Up to 76% of athletes and 68% of nonathletes had a perception score of ≤ 0.5 at 20% fall in FEV1 following methacholine. Athletes with EIB/airway hyperresponsiveness (AHR) had lower perception slopes to methacholine than nonathletes with asthma for breathlessness only (P = .02). Among athletes, those with EIB/AHR had a greater perception slope to EVH for breathlessness and wheezing (P = .02). Female athletes had a higher perception slope for breathlessness after EVH and cough after methacholine compared with men (P < .05). The age of athletes correlated significantly with the perception slope to EVH for each symptom (P < .05).

Conclusions:  Minimal differences in perception of bronchoconstriction-related symptoms between athletes and nonathletes were observed. Among athletes, the presence of EIB/AHR, older age, and female sex were associated with slightly higher perception scores.

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