Reference Values of Cardiopulmonary Exercise Test Parameters in the Contemporary Paediatric Population

• Published in: Sports medicine - open Vol. 9; no. 1; pp. 68 - 12
• Main Authors: Amedro, Pascal, Matecki, Stefan, Pereira dos Santos, Taissa, Guillaumont, Sophie, Rhodes, Jonathan, Yin, Suellen Moli, Hager, Alfred, Hock, Julia, De La Villeon, Gregoire, Moreau, Johan, Requirand, Anne, Souilla, Luc, Vincenti, Marie, Picot, Marie-Christine, Huguet, Helena, Mura, Thibault, Gavotto, Arthur
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-08-2023; Springer Nature B.V; Springer; SpringerOpen
• Subjects: Aerobic exercise; Anaerobic threshold; Children; Chronic illnesses; Human health and pathology; Life Sciences; Maximal breathing capacity; Medicine; Medicine & Public Health; NCT; NCT04876209; Original; Original Research Article; Pediatrics; Physical fitness; Santé publique et épidémiologie; Sports Medicine; Tissues and Organs; Z-score; Z-score; Physical fitness; Maximal breathing capacity; Children; Aerobic exercise
• ISSN: 2198-9761; 2199-1170; 2198-9761
• DOI: 10.1186/s40798-023-00622-3

Background
The evaluation of health status by cardiopulmonary exercise test (CPET) has shown increasing interest in the paediatric population. Our group recently established reference Z-score values for paediatric cycle ergometer VO
2max
, applicable to normal and extreme weights, from a cohort of 1141 healthy children. There are currently no validated reference values for the other CPET parameters in the paediatric population. This study aimed to establish, from the same cohort, reference Z-score values for the main paediatric cycle ergometer CPET parameters, apart from VO
2max
.
Results
In this cross-sectional study, 909 healthy children aged 5–18 years old underwent a CPET. Linear, quadratic, and polynomial mathematical regression equations were applied to identify the best CPET parameters Z-scores, according to anthropometric parameters (sex, age, height, weight, and BMI). This study provided Z-scores for maximal CPET parameters (heart rate, respiratory exchange ratio, workload, and oxygen pulse), submaximal CPET parameters (ventilatory anaerobic threshold, VE/VCO
2
slope, and oxygen uptake efficiency slope), and maximum ventilatory CPET parameters (tidal volume, respiratory rate, breathing reserve, and ventilatory equivalent for CO
2
and O
2
).
Conclusions
This study defined paediatric reference Z-score values for the main cycle ergometer CPET parameters, in addition to the existing reference values for VO
2max
, applicable to children of normal and extreme weights. Providing Z-scores for CPET parameters in the paediatric population should be useful in the follow-up of children with various chronic diseases. Thus, new paediatric research fields are opening up, such as prognostic studies and clinical trials using cardiopulmonary fitness outcomes.
Trial registration
NCT04876209—Registered 6 May 2021—Retrospectively registered,
https://clinicaltrials.gov/ct2/show/NCT04876209
.
Key Points
The dissemination of CPET in paediatrics requires valid paediatric reference values to define the upper and lower normal limits for the main parameters, in addition to the existing reference values for VO
2max
.
The paediatric cycle ergometer CPET reference values were generated using the best mathematical model for the Z-score construction, according to the main anthropometric predictors (sex, age, height, weight, and BMI).
Providing Z-scores for the main cycle ergometer CPET parameters in the paediatric population will be useful in the follow-up of children with chronic diseases.