Assessment of oxygen-uptake efficiency slope in healthy children and children with heart disease: Generation of appropriate reference values for the OUES variable

Hossri, Carlos Alberto Cordeiro; Souza, Isabela Pm Alves de; Oliveira, Joana; Mastrocola, Luiz Eduardo

doi:10.1177/2047487318807977

Cited by 27 publications

(21 citation statements)

References 19 publications

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“…Some important predictive outcomes from the CPET, as OEUS, were not given in most studies. 38 The dropout rate was 15%, most studies did not describe the exact reasons for patients who discontinued participating in the training programme, possibly these patients experienced negative effects of the training. Another important question that remains unanswered is what the effect of training is on the long-term.…”

Section: Limitations Of Included Studiesmentioning

confidence: 99%

Physical exercise training in patients with a Fontan circulation: A systematic review

Scheffers

Berg

Ismailova

et al. 2020

European Journal of Preventive Cardiology

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Background Patients with a Fontan circulation have a reduced exercise capacity, which is an important prognostic predictor of morbidity and mortality. A way to increase exercise capacity in Fontan patients might be exercise training. This systematic review assesses the effects of exercise training investigated in Fontan patients in order to provide an overview of current insights. Design and methods Studies evaluating an exercise training intervention in Fontan patients published up to February 2020 were included in this systematic review. Results From 3000 potential studies, 16 studies reported in 22 publications met the inclusion criteria. In total, 264 Fontan patients with mean age range 8.7–31 years, were included. Different training types including inspiratory muscle training, resistance training and aerobic training were investigated. Main outcome measures reported were peak oxygen uptake, cardiac function, lung function, physical activity levels and quality of life. Peak oxygen uptake increased significantly in 56% of the studies after training with an overall mean increase of +1.72 ml/kg/min (+6.3%). None of the studies reported negative outcome measures related to the exercise programme. In four studies an adverse event was reported, most likely unrelated to the training intervention. Conclusions Exercise training in Fontan patients is most likely safe and has positive effects on exercise capacity, cardiac function and quality of life. Therefore exercise training in Fontan patients should be encouraged. Further studies are required to assess the optimal training type, intensity, duration and long-term effects.

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Section: Limitations Of Included Studiesmentioning

confidence: 99%

Physical exercise training in patients with a Fontan circulation: A systematic review

Scheffers

Berg

Ismailova

et al. 2020

European Journal of Preventive Cardiology

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“…No results in adults were found. Five studies reported oxygen uptake efficiency slope (OUES) values, two in adults [42,43], two in a pediatric population [29,34], and one study reporting up to young adulthood (21 years of age) [44].…”

Section: Breathing Frequency At Peak Exercisementioning

confidence: 99%

Reference values for cardiopulmonary exercise testing in healthy subjects – an updated systematic review

Takken

Mylius

Paap

et al. 2019

Expert Review of Cardiovascular Therapy

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Introduction: Reference values for cardiopulmonary exercise testing (CPET) parameters provide the comparative basis for answering important questions concerning the normalcy of exercise responses in patients, and significantly impacts the clinical decision-making process. Areas covered: The aim of this study was to provide an updated systematic review of the literature on reference values for CPET parameters in healthy subjects across the life span. A systematic search in MEDLINE, Embase, and PEDro databases were performed for articles describing reference values for CPET published between March 2014 and February 2019. Expert opinion: Compared to the review published in 2014, more data have been published in the last five years compared to the 35 years before. However, there is still a lot of progress to be made. Quality can be further improved by performing a power analysis, a good quality assurance of equipment and methodologies, and by validating the developed reference equation in an independent (sub)sample. Methodological quality of future studies can be further improved by measuring and reporting the level of physical activity, by reporting values for different racial groups within a cohort as well as by the exclusion of smokers in the sample studied. Normal reference ranges should be well defined in consensus statements.

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“…1 When there are significant differences in these parameters between patients and healthy controls, as in the study by Hossri et al., care has to be taken when interpreting the results. 4 A low exercise capacity might be caused just by an increased body mass, for example.…”

Section: Oxygen Uptake Efficiency Slopementioning

confidence: 99%

Oxygen uptake efficiency slope in children: Its role in exercise testing

Harkel

Takken

2019

European Journal of Preventive Cardiology

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Cardiopulmonary exercise testing (CPET) is a useful tool to test the physiological response of the cardiovascular, pulmonary and metabolic systems to exercise. Various parameters have previously been recognised as important to predict prognosis, and many of them show correlations with health outcomes. 1,2 The simplest measures are peak work rate, heart rate (HR) increase during exercise and its decline during the recovery phase. The highest obtained HR during exercise (HR peak) is related to the chronotropic competence of the heart. Especially in children, beyond moderate intensity exercise there is a strong correlation between HR and work rate. The recovery of HR after the cessation of exercise is mainly driven by the parasympathetic part of the autonomic nervous system. 3 In different studies this parameter is strongly related to outcome and prognosis. When a respiratory gas analysis system is available, ventilation (VE), oxygen uptake (VO 2) and carbon dioxide production (VCO 2) can be measured continuously. Subsequently, parameters such as maximal oxygen uptake (VO 2max), VE/ VCO 2 slope and the oxygen uptake efficiency slope (OUES) can be obtained.

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Assessment of oxygen-uptake efficiency slope in healthy children and children with heart disease: Generation of appropriate reference values for the OUES variable

Cited by 27 publications

References 19 publications

Physical exercise training in patients with a Fontan circulation: A systematic review

Physical exercise training in patients with a Fontan circulation: A systematic review

Reference values for cardiopulmonary exercise testing in healthy subjects – an updated systematic review

Oxygen uptake efficiency slope in children: Its role in exercise testing

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