The purpose is to assess visualize the level of laryngeal obstruction and vocal cord dysfunction and to obtain more information on causes for dyspnea in asthma and severe asthma and to assess safety of CLE in patients with asthma and with severe asthma. Patients are examined if symptomatic during exercise.
* Questionnaires to assess breathlessness before the test. * CLE on ergometer bicycle using any laryngoscopy setup * Ergometry with spirometry tests with ECG, oxygen saturation, blood pressure, inspiratory and expiratory flow volume curves, bronchodilator after the exercise test * Work load of 40W with 3 minutes intervals and increase by 40W in women. In men, work load of 50W with 3 minutes intervals and increase by 50W starting from 50W. In elderly and more severely disease work load of 30W with 3 minutes intervals and increase by 30W. * Recording of dyspnoea, leg fatigue and chest discomfort * Assessment of asthma by asthma control test, spirometry, exhaled NO measurements. * Severe asthma group: physician-diagnosed asthma, moderate-high dose inhaled glucorticoid steroids and a second controller drug, exacerbations and per oral glucocorticoid steroid courses at least 2 in the past 12 months and/or 50% of the past 12 months on per oral glucocorticoidsteroids
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Continuous laryngoscopy during exercise test
Helsinki University Central Hospital
Helsinki, Finland
Laryngeal obstruction
Semi-quantitative visual estimation of laryngeal obstruction in test
Time frame: From immediately before (-5 minutes) before the exercise test, during the test up to 30 minutes
Safety of CLE in asthma (Incidence of test-emergent adverse events)
Incidence of test-emergent adverse events: nasal bleeding or pain, panic attack, bronchial obstruction.
Time frame: From immediately before (-10 minutes) before the exercise test, during the test up to 30 minutes
Exercise capacity in CLE in asthma
Maximal work load in exercise test measured by W max 4 min
Time frame: From 0 minutes before the exercise test and during the test up to 30 minutes
Dyspnea in CLE in asthma
Assessment of patient reported dyspnea in maximal exercise measured by scale from 0 to 10 (Borg's scale) (0 no symptoms - 10 maximal dyspnea)
Time frame: From 0 minutes before the exercise test and during the test up to 30 minutes
Exercise induced lung function changes
Change from baseline FEV1 after the test
Time frame: Immediately before test (0 minutes), and 10 minutes and 20 minutes after the test
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