Background: The exercise challenge test (ECT) is a common tool for assessment of asthma in children. Many studies suggest that the ''time to maximal bronchoconstriction'' (Nadir-t) after exercise challenge in asthmatic children may be age-dependent, although this has never been systematically studied. Such findings may influence epidemiological surveys where the schedule of post-exercise measurements is trimmed. This study systematically assesses the relation between age and time to maximal bronchoconstriction post-ECT. Methods: Data were collected retrospectively from 131 subjects (87 male; 3e18 years) who were referred for ECT. The routine ECT was performed according to ATS recommendation of a 6-min run. Spirometry was measured at 1, 3, 5, 10, 15, and 20 min post-exercise. The post-exercise nadir of FEV 1 (%baseline) (FEV 1 -nadir) and the time to maximal fall in Nadir-t (minutes) were sought and values were related to age. Results: Baseline FEV 1 values (mean AE SD) were 90.5 AE 13.8% predicted. FEV 1 -nadir was À23.6 AE 11.7% from baseline values. The Nadir-t was reached at 5.1 AE 2.6 min (range 2e12 min). A positive correlation between children's age and Nadir-t was observed (r 2 Z 0.542; SD of residuals Z 1.79; p < 0.001), regardless of FEV 1 -nadir, whether the cutoff of point was À10% or À15% of baseline FEV 1 . Children <10 years of age showed Nadir-t at 3.4 AE 1.7 min post-exercise and older children at 6.6 AE 2.5 min post-exercise (p < 0.0001).
Conclusion:Our results indicate that the time to maximal bronchoconstriction is agedependent in children and adolescents, and imply that the schedule of post-exercise FEV 1 measurements should be cautiously trimmed.