Clinical stress testing in the pediatric age group: a statement from the American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth.

Circulation (Impact Factor: 14.95). 05/2006; 113(15):1905-20. DOI: 10.1161/CIRCULATIONAHA.106.174375
Source: PubMed

ABSTRACT This statement is an updated report of the American Heart Association's previous publications on exercise in children. In this statement, exercise laboratory requirements for environment, equipment, staffing, and procedures are presented. Indications and contraindications to stress testing are discussed, as are types of testing protocols and the use of pharmacological stress protocols. Current stress laboratory practices are reviewed on the basis of a survey of pediatric cardiology training programs.

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    ABSTRACT: Purpose We aimed to provide comprehensive data on and reference values for cardiorespiratory fitness, respiratory function and hemodynamic responses during and after maximal cycle ergometer test in children. Methods The participants were a population sample of 140 children (69 girls) aged 9–11 years. Heart rate (HR) and systolic blood pressure (SBP) were measured from pre-exercise rest to the end of recovery. Respiratory gases were measured directly by the breath-by-breath method. Peak workload, HR changes, peak oxygen uptake (VO2), peak oxygen pulse (O2 pulse), peak respiratory exchange ratio (RER) and the lowest ratio of ventilation and carbon dioxide output (VE/VCO2) during the exercise test in girls and boys were presented according to their distributions in 5 categories. Results HR decreased more during 4-min recovery in boys than in girls (76 vs. 67 beats/min, p p = 0.66). Boys had a higher peak VO2 per weight [51.9 vs. 47.6 ml/kg/min, p p 2 pulse per lean mass was higher in boys than in girls (0.34 vs. 0.31 ml/kg/beat, p VCO2 during the test between boys and girls (28 vs. 29, p = 0.18). Conclusions The indicators of cardiorespiratory fitness were better in boys than in girls. These data enable the evaluation of cardiorespiratory function during and after maximal exercise test and the detection of children with abnormal values.
    Arbeitsphysiologie 10/2014; 115(2). DOI:10.1007/s00421-014-3013-8 · 2.30 Impact Factor
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    ABSTRACT: Exercise and subsequent catabolism is a potential trigger for creatine kinase (CK) concentration increase (rhabdomyolysis) in patients with LCHADD, therefore we evaluated the clinical and biochemical stability under physical exertion conditions at the age of 13 years in a currently 14-year-old LCHADD patient treated with heptanoate.LCHADD was diagnosed during first decompensation at age 20 months. In the following 2 years, the patient had several episodes of rhabdomyolysis. Heptanoate 0.5-1 g/kg/day was started at 4 years, with no further CK elevations since. He is clinically stable, has retinopathy without vision impairment or polyneuropathy. Maximal incremental and endurance exercise tests were performed to evaluate both clinical and metabolic stability during and after exertion.Physical fitness was adequate for age (maximum blood lactate 7.0 mmol/L, appropriate lactate performance curve, maximum heart rate of 196 bpm, maximum power 139 Watt = 2.68 Watt/kg body weight). There were no signs of clinical (muscle pain, dark urine) or metabolic derangement (stable CK, acyl carnitine profiles, blood gas analyses) - neither after maximal incremental nor endurance exertion.This case illustrates that both under maximal incremental and endurance exertion, clinical and biochemical parameters remained stable in this currently 14-year-old LCHADD patient receiving heptanoate treatment.
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    ABSTRACT: To prescribe feasible and medically safe exercise interventions for obese adolescents, it remains to be determined whether exercise tolerance is altered and whether anomalous cardiopulmonary responses during maximal exercise testing are present. Studies that examined cardiopulmonary responses to maximal exercise testing in obese adolescents were searched: cardiopulmonary exercise tests with respiratory gas exchange measurements of peak oxygen uptake (VO2peak) were performed and comparisons between obese and lean adolescents were made. Study quality was assessed using a standardized item list. By meta-analyses VO2peak, peak cycling power output (Wpeak) and peak heart rate (HRpeak) were compared between groups. Nine articles were selected (333 obese vs. 145 lean adolescents). VO2peak (L min−1), HRpeak and Wpeak were not different between groups (P ≥ 0.10), while a trend was found for a reduced VO2peak (mL min−1 kg−1 lean tissue mass) (P = 0.07) in obese vs. lean adolescents. It remained uncertain whether anomalous cardiopulmonary responses occur during maximal exercise testing in obese adolescents. In conclusion, a trend was found for lowered VO2peak (mL min−1 kg−1 lean tissue mass) in obese vs. lean adolescents. Whether cardiopulmonary anomalies during maximal exercise testing would occur in obese adolescents remains uncertain. Studies are therefore warranted to examine the cardiopulmonary response during maximal exercise testing in obese adolescents.
    Obesity Reviews 09/2014; 15(11). DOI:10.1111/obr.12202 · 7.86 Impact Factor


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