Diagnostic accuracy of metronome‐paced tachypnea to detect dynamic hyperinflation. (2nd September 2012)

• Record Type: Journal Article
• Authors: Lahaije, Anke J. M. C.; Willems, Laura M.; van, Hieronymus W. H.; Dekhuijzen, P. N. Richard; van, Hanneke A. C.; Heijdra, Yvonne F.
• Is Part Of: Clinical physiology and functional imaging. Volume 33:Number 1(2013:Jan.)
• Page Start: 62
• Page End: 69
• Publication Date: 2012-09-02
• Subjects: Physiology, Pathological -- Periodicals; Diagnostic imaging -- Periodicals; 612
• DOI: 10.1111/j.1475-097X.2012.01164.x
• Languages: English
• ISSNs: 1475-0961

Abstract

<abstract abstract-type="main" id="cpf1164-abs-0001"> <title>Summary</title> <sec id="cpf1164-sec-0001" sec-type="section"> <title>Introduction</title> <p>This prospective study was carried out to investigate if metronome‐paced tachypnea (MPT) can serve as an accurate diagnostic tool to identify patients with chronic obstructive pulmonary disease (COPD) who are susceptible to develop dynamic hyperinflation during exercise. Commonly, this is assessed by measuring change in inspiratory capacity (IC) during cardiopulmonary exercise testing (CPET), which, however, is complex and laborious.</p> </sec> <sec id="cpf1164-sec-0002" sec-type="section"> <title>Methods</title> <p>Fifty‐three patients with COPD (FEV<sub>1</sub> 58 ± 22%pred) and 20 age‐matched healthy subjects were characterized by lung function testing and performed CPET (reference standard) and MPT. The repeatability coefficient of IC (10·2%) was used as cut‐off to classify subjects as hyperinflators during CPET. Subsequently, dynamic hyperinflation was measured after MPT. With receiver operating characteristic analysis, the optimal cut‐off for MPT‐induced dynamic hyperinflation was determined and sensitivity and specificity of MPT to identify hyperinflators were evaluated.</p> </sec> <sec id="cpf1164-sec-0003" sec-type="section"> <title>Results</title> <p>With 10·2% decrease in IC as cut‐off for CPET‐induced dynamic hyperinflation, the optimal cut‐off for MPT was 11·1% decrease in IC. Using these cut‐offs, MPT had a sensitivity of 85% and specificity of 85% to identify the subjects who hyperinflated during CPET.</p> </sec> <sec id="cpf1164-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The MPT test shows good overall accuracy to identify subjects who are susceptible to develop dynamic hyperinflation during CPET. Before considering the use of MPT as a screening tool for dynamic hyperinflation in COPD, sensitivity and specificity need further evaluation.</p> </sec> </abstract>