Maximal Voluntary Breath-Holding Tele-Inspiratory Test in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Maximal voluntary inspiratory breath-holding time (MVIBHT) has proved to be of clinical utility in some obstructive ventilatory defects. This study aims to correlate the breath-holding time with pulmonary function tests in patients with chronic obstructive pulmonary disease (COPD) and to determine the feasibility of using a breath-holding test in assessing the severity of COPD.A cross-sectional study including male patients with stable COPD were conducted. Patients with respiratory comorbidities and severe or unstable cardiac diseases were excluded. Patients were interviewed and examined. Six-minute walk test (6MWT) and plethysmography were performed.For MVIBHT collection, the subject was asked to inspire deeply and to hold the breath as long as possible at the maximum inspiratory level. This maneuver was repeated three times. The best value was used for further analysis.A total of 79 patients (mean age: 64.2 ± 8) were included in this study. The mean value of MVIBHT was 24.2 ± 8.5 s. We identified a positive and significant correlations between MVIBHT and forced vital capacity (r = .630; p < .001) as well as MVIBHT and forced expiratory volume in 1 s (FEV1%) (r = .671; p < .001). A significant inverse correlation with total lung capacity (r = -.328; p = .019) and residual volume to total lung capacity ratio (r = -.607; p < .001) was noted. MVIBHT was significantly correlated to the distance in the 6MWT (r = .494; p < .001). The mean MVIBHT was significantly different within spirometric grades (p < .001) and GOLD groups (p = .002). At 20.5 s, MVIBHT had a sensitivity of 72% and specificity of 96% in determining COPD patients with FEV1 <50%.Our results provide additional evidence of the usefulness of MVIBHT in COPD patients as a pulmonary function parameter.

Keywords: apnea; breathing test; chronic obstructive pulmonary disease; pulmonary function; six minute walk test; spirometry.

Figure 1.

Variation of maximal voluntary inspiratory breath-holding time according to the FEV1 (%). MVIBHT, maximal voluntary inspiratory breath-holding time. FEV1, forced expiratory volume in the first second. Description: MVIBHT was significantly correlated with FEV1 (r = .686; p < .001).

Figure 2.

Variation of maximal voluntary inspiratory breath-holding time according to BODE score. MVIBHT = maximal voluntary inspiratory breath-holding time. Description: The MVIBHT was statistically different among the mean of MVIBHT for BODE index groups (p = .002).