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 journalReview article

Abstract

Peak oxygen uptake (peak V ˙ O 2 ) 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 V ˙ O 2 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 V ˙ O 2 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 V ˙ O 2 , and thereby convince clinicians of its merit, stimulating future clinical investigators to broaden the application of exercise testing in pediatrics.

Original languageEnglish (US)
JournalChildren (Basel, Switzerland)
Volume4
Issue number1
DOIs
StatePublished - Jan 24 2017

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Exercise
Pediatrics
Oxygen
Biomarkers
Research Personnel
Benchmarking
Sickle Cell Anemia
Pulmonary Hypertension
Cystic Fibrosis
Young Adult
Heart Diseases
Clinical Trials
Mortality
Population

Keywords

  • Journal Article
  • Review

Cite this

Pianosi, Paolo T ; Liem, Robert I ; McMurray, Robert G ; Cerny, Frank J ; Falk, Bareket ; Kemper, Han C G. / Pediatric Exercise Testing : Value and Implications of Peak Oxygen Uptake. In: Children (Basel, Switzerland). 2017 ; Vol. 4, No. 1.
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Pediatric Exercise Testing : Value and Implications of Peak Oxygen Uptake. / Pianosi, Paolo T; Liem, Robert I; McMurray, Robert G; Cerny, Frank J; Falk, Bareket; Kemper, Han C G.

In: Children (Basel, Switzerland), Vol. 4, No. 1, 24.01.2017.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Pediatric Exercise Testing

T2 - Value and Implications of Peak Oxygen Uptake

AU - Pianosi, Paolo T

AU - Liem, Robert I

AU - McMurray, Robert G

AU - Cerny, Frank J

AU - Falk, Bareket

AU - Kemper, Han C G

PY - 2017/1/24

Y1 - 2017/1/24

N2 - Peak oxygen uptake (peak V ˙ O 2 ) 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 V ˙ O 2 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 V ˙ O 2 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 V ˙ O 2 , and thereby convince clinicians of its merit, stimulating future clinical investigators to broaden the application of exercise testing in pediatrics.

AB - Peak oxygen uptake (peak V ˙ O 2 ) 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 V ˙ O 2 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 V ˙ O 2 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 V ˙ O 2 , and thereby convince clinicians of its merit, stimulating future clinical investigators to broaden the application of exercise testing in pediatrics.

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