Introduction to Cardiopulmonary Exercise Testing
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Cardiovascular variables obtained from the tests are shown in Table 3.
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Exercise time was higher in boys. On the other hand, CPE rose with age, without differences according to gender.. Cardiovascular variables during exercise, according to gender and age.. Data obtained from cardiopulmonary variables are shown in Table 4. RER peak increased with age and correlated positively with HR peak and exercise time. Peak oxygen uptake was higher in boys at every age and had strong positive associations with age, weight, height and BSA. However, the correlation between age and VO 2 peak was reduced when children were older than 13 years Fig.
We performed a multiple regression model to predict VO 2 peak achieved, including age, weight, and height. Among these variables, height was the strongest predictor of VO 2 peak, among both boys and girls Fig. Respiratory gas exchange responses during exercise-testing according to age..
Predicted VO 2 was estimated using the equation proposed by Cooper only for ages between 6 and 17 years.. The association between measured and predicted peak oxygen uptake VO 2 peak , using a multiple regression model that includes height and gender.. VO 2 was estimated in the absence of expired gas analysis using exercise test performance variables. Finally, minute ventilation increased with age and was higher among boys..
Cardiopulmonary exercise testing
The association between the linear regression model estimated VO 2 and actual VO 2 values. The main goal of this analysis was to provide CPET reference values for children and adolescents. CPET behavior has been reported by other research groups 7,9 in children above 8 years using a cycle ergometer. This current study adds information in terms of younger children beginning at 4 years , and among individuals using a treadmill.
However, further studies are needed to achieve a better understanding of cardiopulmonary performance at younger ages. Although energy transformation is closely correlated with tissue oxygen uptake, this association can vary widely, since workload is only one of several factors that require higher energy expenditure. Traditionally, in a treadmill exercise protocol, speed and elevation increase with time, so ET can be used as a surrogate variable for workload.
The maximum heart rate is traditionally described as a major determinant of VO 2 at peak exercise. Interestingly, we found that among children, HR peak and age were positively associated. HR peak was slightly lower in our population than those reported by Ten Harkel et al. Mexico City m above sea level.. Performing exercise at high altitude can result in a reduced sympathetic nervous system effect on heart rate.
Other factors affecting maximal heart rate in response to dynamic exercise include age, gender, level of fitness, cardiovascular disease, bed rest, type of exercise, and the extent to which maximal exertion was achieved.
A clinician's guide to cardiopulmonary exercise testing 1 : an introduction
Children in the current study reached higher values for RER peak 1. VO 2 peak increased closely with height, and the regression equation that we obtained to estimate VO 2 peak paralleled that proposed by Cooper et al. We also observed that children reached higher RER peak values and lower VO 2 peak values than those reported by other groups. This could be due to environmental conditions such as air pollution, altitude or even individual variables such as genetics, height or weight..
Among adults, it is common in clinical practice to estimate VO 2 peak indirectly using one of several regression equations; most of these equations use only the work rate achieved. However, these regression equations provide only modest accuracy r values ranging from 0. As other authors have described, we found that VO 2 values correlate better with height than with age or weight in children.
Ten Harkel et al. These results suggest some potentially useful avenues for future investigation, including a comparison of cardiopulmonary variables between children with congenital heart disease and healthy populations, assessing physiological phenomena related to the cardiorespiratory response to exercise in children and to establish new prognostic variables in children with heart disease.
Among adults, CPET variables are frequently used to help make decisions regarding listing for heart transplantation. More information is needed to determine the predictive power of CPET responses among children with heart disease. Another possible application of these data is the comparison of normal standards from CPET to those obtained from young high-performance athletes. We studied a group of children who were initially referred to a pediatric cardiologist to assess cardiovascular disease. Although illness was ruled out, the sample was no doubt biased.
There are some variables that could provide more information about exercise performance, such as air pollution levels, socioeconomic, dietary, or other factors that were not considered.. This study provides physiological response to cardiopulmonary exercise testing using a treadmill among children without heart disease. CPET can be safely and effectively performed in children, even as young as 4 years of age.
Age, gender and height are strongly associated with exercise time, heart rate peak and reserve and oxygen uptake. Authors declare no conflict of interest.. See more Follow us:. Previous article Next article. Issue 3.
Pages July - September Cardiopulmonary exercise testing in healthy children and adolescents at moderately high altitude. Download PDF. Corresponding author. This item has received. Article information. Show more Show less. Table 1. Table 2. Table 3.
Table 4. Table 5. Objective Cardiopulmonary exercise testing is a tool that helps clinicians to establish diagnosis and calculate risk stratification in adults.
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The goal of this study was to describe reference values for cardiopulmonary performance of healthy children. Methods This study included apparently healthy children aged from 4 to 18 years; 61 boys , who underwent cardiopulmonary test using a treadmill protocol. All tests took place at m above sea level Mexico City. Conclusion This study provides physiological values for the major cardiopulmonary variables obtained from exercise testing using a treadmill among healthy children. Regression equations for predicting peak heart rate and peak oxygen uptake are presented as reference values that allow researchers to compare children with heart disease versus those who are healthy.
Cardiopulmonary exercise testing. Palabras clave:. Prueba de ejercicio cardiopulmonar. Introduction Exercise testing is a well recognized tool for assessing cardiovascular function in a wide range of individuals, from patients with heart disease to high performance athletes.
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Therefore, the purpose of this study was to describe the cardiopulmonary response to exercise and assess associations among exercise and demographic variables, in a group of apparently healthy children and adolescents. Methods Children and adolescents, from 4 to 18 years of age, were evaluated at the pediatric cardiology consultation room, most of them suspected of having a cardiac murmur.
A cardiac defibrillator and a fully stocked resuscitation cart were present at all times. Exercise protocol All exercise tests were performed at an altitude of m above sea level. Following the 3 min walking period, subjects rested in the supine position for an additional 5 min. Treadmill exercise testing protocol MET per minute. The corresponding changes in the speed and incline of the treadmill, were calculated from the equations proposed by the ACSM. Baseline characteristics from healthy children, according to age quartile. Cardiovascular variables during exercise, according to gender and age.
Respiratory gas exchange responses during exercise-testing according to age.