Clinical and Cardiorespiratory Assessment in Children With Down Syndrome Without Congenital Heart Disease

Abstract

Objective: To assess the clinical and functional status of a young Down syndrome (DS) population without congenital heart disease.Design: Prospective study of children with DS and control subjects.Setting: Bambino Gesù Children's Hospital, Rome, Italy.Participants and Methods: Forty-two children with DS (mean ± SD age, 9.8 ± 3.6 years) underwent genetic, clinical, neuropsychological (IQ), and cardiorespiratory evaluation. Cardiorespiratory fitness was assessed with a treadmill test and a lung function test to determine forced vital capacity, first-second forced expiratory volume, and peak expiratory flow. Data were expressed as a percentage of the predicted values for control children. To assess cooperation during exercise testing, we devised a compliance scale assigning a score according to the subjects' ability to understand instructions, ability to walk and run as required, and need for vocal encouragement.Results: Eighteen (43%) of 42 children with DS were obese, 10 (24%) were short, and 17 (40%) had microcephaly. On the Leiter International Performance Scale, 2 of 35 subjects had a normal IQ score (80-120); all others had low IQ scores (79 to Ͻ40). Five subjects did not undergo cardiorespiratory assessment. Eighteen of 37 subjects completed lung function tests: the results for 10 were unremarkable, and results from 8 revealed reduced forced vital capacity because of poor compliance. The subjects tested had low exercise tolerance (mean ± SD tolerance percentage, 61% ± 12%), mild tachycardia (maximal heart rate, 91% ± 4%), and a mild hypertensive response (maximal blood pressure, 89% ± 8%). Compliance scores correlated significantly with exercise time and age but not with IQ.Conclusions: Clinical and cardiorespiratory assessment is feasible in subjects with DS without congenital heart disease and should be useful in gauging their fitness level for safe physical activity.Arch Pediatr Adolesc Med. 2000;154:408-410

Evaluation of Left Ventricle Systolic and Diastolic Functions by Tissue Doppler Echocardiography in Children with Down Syndrome

“…Our study agreed with the results of these reports, which indicated a significantly higher heart rate in Down syndrome subjects than in normal children (21)(22)(23). This finding is considered to be due to the autonomic cardiac dysfunction occurring at the central brain stem site as a result of a genetic disorder (24).…”

Hormonal and autonomic responses to autonomic stimulation are altered in young men with Down syndrome

“…Anthropometric characteristics of DS observed in our study correspond to the classical profile of subjects with Down syndrome, with small height and high relative weight [22,23]. .001: significant difference between the 2 tests conditions..…”

Comparison of some Anthropometric Parameters and Blood Pressure between Adolescents with Down Syndrome and Healthy Ones

“…Children with Down syndrome have a smaller head circumference than healthy children ( 5 , 21 ). In terms of heart rate and blood pressure parameters, the groups differ only in systolic blood pressure ( P <0.05) where children with Down syndrome had higher blood pressure than normal children, a similar result obtained ( 22 ). Heart rate and blood pressure parameters were stimulated by a submaximal physical activity, and post-activity measurements showed a similar trend as before the exertion with the only difference being that diastolic pressure ( P <0.05) was higher in healthy children.…”