Overshoot of the Respiratory Exchange Ratio during Recovery from Maximal Exercise Testing in Young Patients with Congenital Heart Disease

Vecchiato, Marco; Ermolao, Andrea; Zanardo, Emanuele; Battista, Francesca; Ruvoletto, Giacomo; Palermi, Stefano; Quinto, Giulia; Degano, Gino; Gasperetti, Andrea; Padalino, Massimo A.; Salvo, Giovanni Di; Neunhäeuserer, Daniel

doi:10.3390/children10030521

Cited by 6 publications

(3 citation statements)

References 44 publications

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“…CPET is a valuable tool to evaluate the responses of the cardiac, pulmonary, vascular, and musculoskeletal systems to exercise [ 101 , 102 , 103 , 104 ]. Although still underutilized, its high reproducibility offers important prognostic and diagnostic information [ 105 ] and can be integrated with other imaging techniques [ 106 ]. Different from an EST, CPET involves measurements of respiratory oxygen uptake, carbon dioxide production, and ventilatory measures during a symptom-limited exercise test.…”

Section: The Step-by-step Approach To Athlete’s Heartmentioning

confidence: 99%

Athlete's Heart: A Cardiovascular Step-By-Step Multimodality Approach

Palermi¹,

D’Ascenzi²,

Castelletti³

et al. 2023

Rev. Cardiovasc. Med.

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“Athlete’s heart” is a spectrum of morphological, functional, and regulatory changes that occur in people who practice regular and long-term intense physical activity. The morphological characteristics of the athlete’s heart may overlap with some structural and electrical cardiac diseases that may predispose to sudden cardiac death, including inherited and acquired cardiomyopathies, aortopathies and channelopathies. Overdiagnosis should be avoided, while an early identification of underlying cardiac life-threatening disorders is essential to reduce the potential for sudden cardiac death. A step-by-step multimodality approach, including a first-line evaluation with personal and family history, clinical evaluation, 12-lead resting electrocardiography (ECG), followed by second and third-line investigations, as appropriate, including exercise testing, resting and exercise echocardiography, 24-hour ECG Holter monitoring, cardiac magnetic resonance, computed tomography, nuclear scintigraphy, or genetic testing, can be determinant to differentiate between extreme physiology adaptations and cardiac pathology. In this context, cardiovascular imaging plays a key role in detecting structural abnormalities in athletes who fall into the grey zone between physiological adaptations and a covert or early phenotype of cardiovascular disease.

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Section: The Step-by-step Approach To Athlete’s Heartmentioning

confidence: 99%

Athlete's Heart: A Cardiovascular Step-By-Step Multimodality Approach

Palermi¹,

D’Ascenzi²,

Castelletti³

et al. 2023

Rev. Cardiovasc. Med.

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“…The RER > 1.0 is regarded as a criterion for maximal effort during CPET. In the recovery phase, the RER shows an overshoot, which is related to aerobic fitness [20].…”

Section: Important Parameters Displayed In the 9-panel Plotmentioning

confidence: 99%

Practical Aspects of Cardiopulmonary Exercise Testing in Children

Takken,

Hulzebos

2023

Int J Sports Med

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The use of cardiopulmonary exercise testing (CPET) in pediatrics provides critical insights into potential physiological causes of unexplained exercise-related complaints or symptoms, as well as specific pathophysiological patterns based on physiological responses or abnormalities. Furthermore, CPET helps evaluate exercise performance in children with chronic (lung/heart) diseases. For instance, it can ascertain any adverse reaction to exercise and estimate the effects of specific treatment measures. It affords a global assessment of the pathophysiological patterns, responses and abnormalities to exercise that is inadequately reflected by resting lung function and/or cardiac function assessment. Clinical interpretation of the results of a CPET in pediatrics requires specific knowledge regarding pathophysiological responses and interpretative strategies that can be adapted to address concerns specific to the child’s medical condition or disability.

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“…In the first paper, Vecchiato and associates from Padova and Naples, Italy, discuss the overshoot of the respiratory exchange ratio during recovery from maximal exercise testing in young patients with congenital heart disease (CHD) [ 2 ]. The authors state that overshoot of the respiratory exchange ratio (RER) following exercise is decreased in subjects with congestive heart failure (CHF).…”

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confidence: 99%