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Diagnostic accuracy of metronome‐paced tachypnea to detect dynamic hyperinflation
Author(s) -
Lahaije Anke J. M. C.,
Willems Laura M.,
Hees Hieronymus W. H.,
Dekhuijzen P. N. Richard,
Helvoort Hanneke A. C.,
Heijdra Yvonne F.
Publication year - 2013
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/j.1475-097x.2012.01164.x
Subject(s) - dynamic hyperinflation , medicine , tachypnea , copd , cardiology , metronome , hyperinflation , respiratory minute volume , lung volumes , lung , respiratory system , monetary policy , rhythm , economics , monetary economics , tachycardia
Summary Introduction 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. Methods Fifty‐three patients with COPD ( FEV 1 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. Results 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 . Conclusions 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.