Subjective fitness relates to performance and can be improved by exercise in children and young adults with heart disease.

Introduction: The Duke Activity Status Index is used to assess an individual patient's perception of their fitness abilities. It has been validated and shown to predict actual fitness in adults but has been studied less in the paediatric population, specifically those with heart disease. This study aims to assess if the Duke Activity Status Index is associated with measured markers of physical fitness in adolescents and young adults with heart disease.

Pulmonary responses following cardiac rehabilitation and the relationship with functional outcomes in children and young adults with heart disease.

Introduction: Patients with congenital heart disease (CHD) often have pulmonary abnormalities and exercise intolerance following cardiac surgery. Cardiac rehabilitation (CR) improves exercise capacity in patients with CHD, but minimal study has been performed to see if resting and dynamic pulmonary performance improves following CR in those with prior cardiac surgery.

Methods: This was a retrospective cohort study of all patients who completed ≥12 weeks of CR from 2018 through 2022.

Facility-Based and Virtual Cardiac Rehabilitation in Young Patients with Heart Disease During the COVID-19 Era.

Cardiac rehabilitation (CR) is an important tool for improving fitness and quality of life in those with heart disease (HD). Few pediatric centers use CR to care for these patients, and virtual CR is rarely used. In addition, it is unclear how the COVID-19 era has changed CR outcomes.

Stable fitness during COVID-19: Results of serial testing in a cohort of youth with heart disease.

Background: Little is known about how sport and school restrictions early during the novel coronavirus 2019 (COVID-19) pandemic impacted exercise performance and body composition in youth with heart disease (HD).

Methods: A retrospective chart review was performed on all patients with HD who had serial exercise testing and body composition bioimpedance analysis performed within 12 months before and during the COVID-19 pandemic. Formal activity restriction was noted as present or absent.

Body Composition and Exercise Performance in Youth With a Fontan Circulation: A Bio-Impedance Based Study.

Background Adults with a Fontan circulation tend to have myopenia and elevated adiposity when measured by dual energy x-ray absorptiometry. Bioelectrical impedance analysis is an alternative validated approach to assess body composition. We used bioelectrical impedance analysis to compare body composition between pediatric patients with a Fontan circulation and control individuals without heart disease.

Peripheral venous pressure changes during exercise are associated with adverse Fontan outcomes.

Objective: Elevated central venous pressure (CVP) plays an important role in the development of adverse Fontan outcomes. Peripheral venous pressure (PVP) has been validated as a surrogate for CVP in Fontan patients. We hypothesised that PVP in response to exercise will be associated with a greater prevalence of Fontan morbidity.

The Adaptation of Pediatric Exercise Testing Programs to the Coronavirus/COVID-19 Pandemic.

Objective: Response to the coronavirus/COVID-19 pandemic has resulted in several initiatives that directly impact hospital operations. There has been minimal information on how COVID-19 has affected exercise testing in pediatric patients.

Design: A web-based survey was designed and sent to pediatric exercise testing laboratories in the United States and Canada.

Skeletal Muscle Mass Is Linked to Cardiorespiratory Fitness in Youth.

Introduction: Cardiorespiratory fitness (CRF) measured by oxygen consumption (V˙O2) during exercise is an important marker of health. The traditional method of indexing V˙O2 to total body mass is suboptimal because skeletal muscle mass (SMM), rather than fat and extracellular fluid, is the main contributor to CRF. The traditional estimating equations for peak V˙O2 in youth do not account for this.

Pulmonary effects on exercise testing in tetralogy of Fallot patients repaired with a transannular patch.

Background: A transannular patch is often used in the contemporary surgical repair of tetralogy of Fallot. This can lead to significant pulmonary insufficiency and increased right ventricular volumes and ultimately pulmonary valve replacement. Cardiopulmonary exercise testing is used to assess exercise capacity in tetralogy of Fallot patients before pulmonary valve replacement.

A Novel Mechanism for Improved Exercise Performance in Pediatric Fontan Patients After Cardiac Rehabilitation.

Patients with a Fontan circulation have impaired exercise capacity. Cardiac rehabilitation (CR) has shown promise in enhancing peak exercise parameters in this population, but an improvement in submaximal exercise has not been consistently demonstrated. We assessed the hypothesis that participation in CR will be associated with more efficient oxygen extraction and ventilation during submaximal exercise.

Cardiopulmonary Aerobic Fitness Assessment During Maximal and Submaximal Exercise Testing in Pediatric Oncology Patients After Chemotherapy.

Purpose: The cardiopulmonary exercise test (CPET) is a valuable tool to assess cardiopulmonary exercise capacity in pediatric oncology patients after chemotherapy. In addition, few studies on the utility of submaximal testing have been performed, which could be important as some patients are unable to complete a maximal effort test secondary to deconditioning by both disease and treatment.

Materials And Methods: We performed a retrospective chart review of pediatric cancer patients exposed to chemotherapy from 1992 to 2013 who underwent CPET with cycle ergometry (n=27).

Pediatric Exercise Stress Laryngoscopy following Laryngotracheoplasty: A Comparative Review.

Objective: Exercise-induced airway obstruction in pediatric patients is a unique phenomenon with multiple potential etiologies. An accurate diagnosis can be challenging to establish in pediatric patients because they are frequently asymptomatic at rest. Exercise stress laryngoscopy (ESL) is a modality by which pediatric patients can be evaluated under physiologic conditions that produce their symptoms.

Exercise capacity improves after transcatheter closure of the Fontan fenestration in children.

Objectives: This study evaluated the aerobic capacity, exercise capacity, and arterial oxygen saturation (O(2)Sat) in children before and after transcatheter Fontan fenestration closure.

Design: Observational study comparing exercise parameters and hemodynamics before and after transcatheter fenestration closure in Fontan patients.

Outcome Measures: Working capacity, exercise duration, oxygen consumption (VO(2)), and arterial O(2)Sat were evaluated during aerobic exercise.

Decreased maximal aerobic capacity in pediatric chronic kidney disease.

Adult and pediatric patients with ESRD have impaired maximum oxygen consumption (VO(2) max), a reflection of the cardiopulmonary system's ability to meet increased metabolic demands. We sought to determine factors associated with decreased VO(2) max in pediatric patients with different stages of CKD. VO(2) max was measured using a standardized exercise testing protocol in patients with stage 2 to 4 chronic kidney disease (CKD) (n = 46), in renal transplant recipients (n = 22), in patients treated with maintenance hemodialysis (n = 12), and in age-matched healthy controls (n = 33).

Exercise evaluation of upper- versus lower-extremity blood pressure gradients in pediatric and young-adult participants.

The aim of this study was to provide a normal reference for arm-leg blood pressure gradients in normal pediatric and young-adult patients before and after exercise. We assessed 216 normal participants by physical or echocardiographic exam, maximally tested using the James Cycle Protocol, with arm and leg blood pressures taken pre- and postexercise. Arm-leg gradients significantly increased from -5 mmHg at rest to 4, 2, and 1 mmHg 1, 3, and 4 min postexercise (p < .

Development of exercise-induced arm-leg blood pressure gradient and abnormal arterial compliance in patients with repaired coarctation of the aorta.

Often, the lack of systemic arterial hypertension and the lack of a resting arm-leg blood pressure gradient are used to assess the adequacy of the anatomic result after intervention for coarctation of the aorta (CoA). Some patients with no arm-leg gradient at rest may develop a gradient with exercise, leading caregivers to question the success of the repair. It is not clear what the prevalence is of patients who have undergone a successful intervention for CoA and have no arm-leg gradient at rest but develop a significant gradient with exercise and which factors may predict the development of an arm-leg gradient with exercise.

Cardiovascular physiology during supine cycle ergometry and dobutamine stress.

Purpose: This study compared cardiac hemodynamics during supine cycle ergometry and dobutamine stress.

Methods: Thirty-two healthy volunteers (19 female, 13 male, 23.5 +/- 3.