Pediatric Exercise Testing: Value and Implications of Peak Oxygen Uptake.
Pediatric Exercise Testing: Value and Implications of Peak Oxygen Uptake.
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DOI：
10.3390/children4010006
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发表时间：
2017-01-24
期刊：
影响因子：
--
通讯作者：
Kemper HC
中科院分区：
文献类型：
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作者：
Pianosi PT;Liem RI;McMurray RG;Cerny FJ;Falk B;Kemper HC
通过临床运动测试测得的峰值摄氧量（峰值）是有氧健身的基准。根据最大跑步机运动量估算的有氧适能是成人死亡率的预测指标。峰值被证明可以预测 25 年前患有囊性纤维化的 7-35 岁患者的寿命。过去十年中，针对患有先天性心脏病的年轻人进行的大量运动研究揭示了重要的预后信息。三年前，第一个针对肺动脉高压儿童的临床试验使用峰值作为终点，同样提供了临床相关数据。心肺运动测试为临床医生提供了生物标志物和临床结果，并为研究人员提供了对反映静息时隐藏的综合生理反应的基本生物机制的新颖见解。这些在多种疾病状态下的开创性观察所带来的动力应该会促使临床医生在其他患者群体中采用类似的方法；例如，镰状细胞病。儿科运动科学的进步将阐明可能识别新生物标志物的新途径。本文的最初目的是强调运动测试确定峰值的临床相关性，从而说服临床医生其优点，激励未来的临床研究人员扩大运动测试在儿科的应用。
Peak oxygen uptake (peak) 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 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 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, and thereby convince clinicians of its merit, stimulating future clinical investigators to broaden the application of exercise testing in pediatrics.