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Article: Maximising the clinical use of exercise gaseous exchange testing in children with repaired cyanotic congenital heart defects: The development of an appropriate test strategy

TitleMaximising the clinical use of exercise gaseous exchange testing in children with repaired cyanotic congenital heart defects: The development of an appropriate test strategy
Authors
Issue Date2000
PublisherAdis International Ltd. The Journal's web site is located at http://sportsmedicine.adisonline.com/pt/
Citation
Sports Medicine, 2000, v. 29 n. 4, p. 229-244 How to Cite?
Abstract
Implicit in deciding upon an exercise test strategy to elucidate cardiopulmonary function in children with congenital heart disease are appropriate application of gas exchange techniques and the significance of the data collected to the specific congenital heart disorder. Post-operative cardiopulmonary responses to exercise in cyanotic disorders are complex and, despite a large body of extant literature in paediatric patients, there has been much difficulty in achieving quality and consistency of data. Maximal oxygen uptake is widely recognised as the best single indicator of cardiopulmonary function and has therefore been the focus of most clinical exercise tests in children. Many children with various heart anomalies are able to exercise to maximum without adverse symptoms, and it is essential that test termination is based on the same criteria for these children. Choosing appropriate, valid indicators of maximum in children with congenital heart disease is beset by difficulties. Such maximal intensity exercise testing procedures have been challenged on the grounds that they do not give a good indication of cardiopulmonary function that is relevant to real life situations. Furthermore, they are prone to much inter-individual variability and error in the definition of maximal exertion. Alternative strategies have been proposed which focus upon dynamic submaximal and kinetic cardiopulmonary responses, which are thought to be less dependent on maximal voluntary effort and more suited to the daily activity patterns of children. These methods are also not without problems. Variability in anaerobic threshold measurements and controversy regarding its physiological meaning have been debated. It is recommended that an appropriate cardiopulmonary exercise gas exchange test strategy, which provides clinically useful information for children with cyanotic congenital heart disease, should include both maximal and submaximal data. The inclusion of oxygen uptake kinetics and ventilatory data are encouraged, since they may allow the distinction between a pulmonary, cardiovascular or inactivity related exercise limitation.
Persistent Identifierhttp://hdl.handle.net/10722/87835
ISSN
2013 Impact Factor: 5.320
2013 SCImago Journal Rankings: 2.771
ISI Accession Number ID

 

Author Affiliations
  1. The University of Hong Kong
DC FieldValueLanguage
dc.contributor.authorMcManus, Aen_HK
dc.contributor.authorLeung, Men_HK
dc.date.accessioned2010-09-06T09:35:06Z-
dc.date.available2010-09-06T09:35:06Z-
dc.date.issued2000en_HK
dc.identifier.citationSports Medicine, 2000, v. 29 n. 4, p. 229-244en_HK
dc.identifier.issn0112-1642en_HK
dc.identifier.urihttp://hdl.handle.net/10722/87835-
dc.description.abstractImplicit in deciding upon an exercise test strategy to elucidate cardiopulmonary function in children with congenital heart disease are appropriate application of gas exchange techniques and the significance of the data collected to the specific congenital heart disorder. Post-operative cardiopulmonary responses to exercise in cyanotic disorders are complex and, despite a large body of extant literature in paediatric patients, there has been much difficulty in achieving quality and consistency of data. Maximal oxygen uptake is widely recognised as the best single indicator of cardiopulmonary function and has therefore been the focus of most clinical exercise tests in children. Many children with various heart anomalies are able to exercise to maximum without adverse symptoms, and it is essential that test termination is based on the same criteria for these children. Choosing appropriate, valid indicators of maximum in children with congenital heart disease is beset by difficulties. Such maximal intensity exercise testing procedures have been challenged on the grounds that they do not give a good indication of cardiopulmonary function that is relevant to real life situations. Furthermore, they are prone to much inter-individual variability and error in the definition of maximal exertion. Alternative strategies have been proposed which focus upon dynamic submaximal and kinetic cardiopulmonary responses, which are thought to be less dependent on maximal voluntary effort and more suited to the daily activity patterns of children. These methods are also not without problems. Variability in anaerobic threshold measurements and controversy regarding its physiological meaning have been debated. It is recommended that an appropriate cardiopulmonary exercise gas exchange test strategy, which provides clinically useful information for children with cyanotic congenital heart disease, should include both maximal and submaximal data. The inclusion of oxygen uptake kinetics and ventilatory data are encouraged, since they may allow the distinction between a pulmonary, cardiovascular or inactivity related exercise limitation.en_HK
dc.languageengen_HK
dc.publisherAdis International Ltd. The Journal's web site is located at http://sportsmedicine.adisonline.com/pt/en_HK
dc.relation.ispartofSports Medicineen_HK
dc.titleMaximising the clinical use of exercise gaseous exchange testing in children with repaired cyanotic congenital heart defects: The development of an appropriate test strategyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0112-1642&volume=29;4&spage=229&epage=244&date=2000&atitle=Maximising+the+clinical+use+of+exercise+gaseous+exchange+testing+in+children+with+repaired+cyanotic+congenital+heart+defects:+the+development+of+an+appropriate+test+strategyen_HK
dc.identifier.emailMcManus, A: alimac@hku.hken_HK
dc.identifier.authorityMcManus, A=rp00936en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid10783899en_HK
dc.identifier.scopuseid_2-s2.0-0033997388en_HK
dc.identifier.hkuros52781en_HK
dc.identifier.volume29en_HK
dc.identifier.issue4en_HK
dc.identifier.spage229en_HK
dc.identifier.epage244en_HK
dc.identifier.isiWOS:000086579000002-
dc.publisher.placeNew Zealanden_HK
dc.identifier.scopusauthoridMcManus, A=7004635919en_HK
dc.identifier.scopusauthoridLeung, M=7201944800en_HK

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