Pediatric exercise testing: Value and implications of peak oxygen uptake

Paolo T. Pianosi; Robert I. Liem; Robert G. McMurray; Frank J. Cerny; Bareket Falk; Han C.G. Kemper

doi:10.3390/children4010006

Pediatric exercise testing: Value and implications of peak oxygen uptake

Paolo T. Pianosi, Robert I. Liem, Robert G. McMurray, Frank J. Cerny, Bareket Falk, Han C.G. Kemper

Research output: Contribution to journal › Review article › peer-review

21 Scopus citations

Abstract

Peak oxygen uptake (peak ˙VO₂ ) measured by clinical exercise testing is the benchmark for aerobic fitness. Aerobic fitness, estimated from maximal treadmill exercise, is a predictor of mortality in adults. Peak ˙VO₂ was shown to predict longevity in patients aged 7–35 years with cystic fibrosis over 25 years ago. A surge of exercise studies in young adults with congenital heart disease over the past decade has revealed significant prognostic information. Three years ago, the first clinical trial in children with pulmonary arterial hypertension used peak ˙VO₂ as an endpoint that likewise delivered clinically relevant data. Cardiopulmonary exercise testing provides clinicians with biomarkers and clinical outcomes, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response hidden at rest. Momentum from these pioneering observations in multiple disease states should impel clinicians to employ similar methods in other patient populations; e.g., sickle cell disease. Advances in pediatric exercise science will elucidate new pathways that may identify novel biomarkers. Our initial aim of this essay is to highlight the clinical relevance of exercise testing to determine peak ˙VO₂, and thereby convince clinicians of its merit, stimulating future clinical investigators to broaden the application of exercise testing in pediatrics.

Original language	English (US)
Article number	6
Journal	Children
Volume	4
Issue number	1
DOIs	https://doi.org/10.3390/children4010006
State	Published - Jan 2017
Externally published	Yes

Bibliographical note

Funding Information:
Funded by grant UL1 TR000153-02S1 from the Clinical and Translational Science Awards Consortium: Child Health Oversight Committee. Principal Investigator: Dan M. Cooper. This effort was supported by NIH through the Clinical and Translational Science Award (CTSA) at the University of California, Irvine (Grant 3UL1RR031985). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Center for Advancing Translational Sciences or the National Institutes of Health.

Funding Information:
Acknowledgments: Funded by grant UL1 TR000153-02S1 from the Clinical and Translational Science Awards Consortium: Child Health Oversight Committee. Principal Investigator: Dan M. Cooper. This effort was supported by NIH through the Clinical and Translational Science Award (CTSA) at the University of California, Irvine (Grant 3UL1RR031985). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Center for Advancing Translational Sciences or the National Institutes of Health. The Pediatric Exercise Network-Working Group: Naveen Ashish; Marcas M. Bamman; Frank J. Cerny; Dan M. Cooper; Pierre D’Hemecourt; Joey C. Eisenmann; Dawn Ericson; John Fahey; Bareket Falk; Davera Gabriel; Michael G. Kahn; Han C. G. Kemper; Szu-Yun Leu; Robert I. Liem; Robert McMurray; Patricia A. Nixon; J. Tod Olin; Paolo T. Pianosi; Mary Purucker; Shlomit Radom-Aizik; Amy Taylor. The authors are indebted to Dawn Ericson for her thoughtful review of preliminary ideas, and Dan M. Cooper whose insight prompted our assembly and whose vision coordinated our efforts.

Publisher Copyright:
© 2017 by the authors; licensee MDPI, Basel, Switzerland.

Keywords

Aerobic fitness
Cardiopulmonary exercise testing
Peak oxygen uptake

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3390/children4010006

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abstract = "Peak oxygen uptake (peak ˙VO2 ) measured by clinical exercise testing is the benchmark for aerobic fitness. Aerobic fitness, estimated from maximal treadmill exercise, is a predictor of mortality in adults. Peak ˙VO2 was shown to predict longevity in patients aged 7–35 years with cystic fibrosis over 25 years ago. A surge of exercise studies in young adults with congenital heart disease over the past decade has revealed significant prognostic information. Three years ago, the first clinical trial in children with pulmonary arterial hypertension used peak ˙VO2 as an endpoint that likewise delivered clinically relevant data. Cardiopulmonary exercise testing provides clinicians with biomarkers and clinical outcomes, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response hidden at rest. Momentum from these pioneering observations in multiple disease states should impel clinicians to employ similar methods in other patient populations; e.g., sickle cell disease. Advances in pediatric exercise science will elucidate new pathways that may identify novel biomarkers. Our initial aim of this essay is to highlight the clinical relevance of exercise testing to determine peak ˙VO2, and thereby convince clinicians of its merit, stimulating future clinical investigators to broaden the application of exercise testing in pediatrics.",

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note = "Funding Information: Funded by grant UL1 TR000153-02S1 from the Clinical and Translational Science Awards Consortium: Child Health Oversight Committee. Principal Investigator: Dan M. Cooper. This effort was supported by NIH through the Clinical and Translational Science Award (CTSA) at the University of California, Irvine (Grant 3UL1RR031985). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Center for Advancing Translational Sciences or the National Institutes of Health. Funding Information: Acknowledgments: Funded by grant UL1 TR000153-02S1 from the Clinical and Translational Science Awards Consortium: Child Health Oversight Committee. Principal Investigator: Dan M. Cooper. This effort was supported by NIH through the Clinical and Translational Science Award (CTSA) at the University of California, Irvine (Grant 3UL1RR031985). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Center for Advancing Translational Sciences or the National Institutes of Health. The Pediatric Exercise Network-Working Group: Naveen Ashish; Marcas M. Bamman; Frank J. Cerny; Dan M. Cooper; Pierre D{\textquoteright}Hemecourt; Joey C. Eisenmann; Dawn Ericson; John Fahey; Bareket Falk; Davera Gabriel; Michael G. Kahn; Han C. G. Kemper; Szu-Yun Leu; Robert I. Liem; Robert McMurray; Patricia A. Nixon; J. Tod Olin; Paolo T. Pianosi; Mary Purucker; Shlomit Radom-Aizik; Amy Taylor. The authors are indebted to Dawn Ericson for her thoughtful review of preliminary ideas, and Dan M. Cooper whose insight prompted our assembly and whose vision coordinated our efforts. Publisher Copyright: {\textcopyright} 2017 by the authors; licensee MDPI, Basel, Switzerland.",

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Pediatric exercise testing: Value and implications of peak oxygen uptake

Abstract

Bibliographical note

Keywords

UN SDGs

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