A meta-analysis of cardiopulmonary exercise testing in pre-pubertal healthy children produces new information

Abstract

The objective of the paper was to analyze cardiopulmonary data and functional capacity in healthy children who have undergone ergospirometry. A systematic meta-analysis review of ergospirometry in children was performed based on reports indexed in PubMed, Bireme, and Embase. End points were age, sex, body mass index, maturation evaluation, the type of ergometer used for ergospirometry, and cardiopulmonary related values (peak heart rate and peak oxygen consumption [VO 2 ]). Twenty articles were selected, which included 3,808 children, averaging 9.1years of age. A treadmill was used in 55% of the trials, and a cycle ergometer in the other 45% studies included in this analysis. The following statistically significant results were found: on subgroup analysis, peak VO 2 values in boys on the treadmill was 20% higher than peak VO 2 values in girls on the cycle ergometer; peak VO 2 values in boys on the treadmill were 18% greater than that for girls on the same ergometer. BMI was inversely correlated with peak VO 2 in the total analysis, and in female subjects on cycle ergometers. Peak heart rate during the ergospirometrical test was 5.6 BPM higher than the estimated 95% maximum heart rate. Most of the ergospirometrical parameters had not been reported in the original trials analyzed here. We conclude that peak VO 2 value for pre-pubertal children are circa 18% higher in boys vs. girls and overall higher in treadmill vs. cycle ergometers.

Functional Class in Children with Idiopathic Dilated Cardiomyopathy. A pilot Study

“…This probably resulted from the fact that peak VO 2 is believed to occur between 13 and 14 years of age, 16 , 21 , 29 i.e., the parameters related to this indicator are expected to be rising during the prepubertal period, phase in which the participants were assessed. 29 , 36 Although a systematic review by the present study's author had shown that peak VO 2 values in prepubertal girls are, on average, 20% lower than those found in prepubertal boys, 37 because of the influence of hormones and body fat, 37 , 38 this finding was not observed here after post-hoc Bonferroni test. We can suppose that the small sample size had a negative influence on the analysis of this variable.…”

“…Even with peak VO 2 values lower than expected, 37 all children reached the maximum test according to the criteria of exercise termination mentioned by ACC/AHA Guidelines Update for Exercise Testing, 39 because the modified Balke protocol used is appropriate to the study population, and the protocol-demanded response to exercise is similar to the physiological response to exercise in children. That is, the time to reach 50% of peak VO 2 values in children is shorter than that for adults; children are less dependent on the glycogenic pathway to meet the demands than adults; the use of fatty acids as an energy source is greater during childhood; and children show lower levels of blood lactate (which makes it more difficult to reach exhaustion), lower pulmonary ventilation (VE, L/min) and lower carbon dioxide production (VCO 2 , mL/min).…”

Use of portable gas analyzers during pediatric field testing

“…Functional and exercise capacity is one of the primary markers of physical condition and the general health of an individual 1,2 and its evaluations are fundamental in health research in school‐aged children, 1,3 especially in the presence of diseases. In this sense, field tests have been routinely applied in clinical care and scientific practice and are often conducted with the use of portable gas analyzers (PGAs) 4‐7 .…”

Rehabilitación cardíaca en el infante y adolescente con cardiopatía congénita corregida

“…A partir del cálculo de la frecuencia cardiaca máxima, se debe calcular los porcentajes de intensidad del entrenamiento teniendo en cuenta la estratificación del riesgo realizada al infante y adolescente con cardiopatía congénita corregida. (Robergs & Landwehr, 2002) (Machado & Denadai,, 2011) (Tavares, Bocchi, Neto, Soares, & Guimarães, 2016) (Cadenas-Sánchez, y otros, 2014).…”