Abstract
Interpretation of change in exercise performance over time in children with repaired congenital heart disease is often hampered by poor effort that limits the maximum heart rate; this is often difficult to distinguish from chronotropic impairment, a common finding in these children. In an attempt to address this limitation, we sought to examine measures of exercise performance that are corrected for heart rate in healthy children and to determine if these change with somatic growth. We studied two serial graded exercise tests in 24 healthy children at an interval of >3 years. Paired comparisons revealed that maximum oxygen pulse (O2 pulse), O2 pulse at ventilatory anaerobic threshold, O2 pulse at a heart rate of 140 beats per minute, and slope of the VO2–heart rate relationship all increased with age. However, when indexed to somatic growth, there was no change in the mean values of these parameters over time. We conclude that O2 pulse and slope of the VO2–heart rate relationship during exercise increase in proportion to somatic growth in children so that optimal oxygen delivery to the exercising muscles is ensured. This study provides the “normative” response of exercise parameters to growth, against which responses of children with repaired congenital heart disease may be compared.
Similar content being viewed by others
References
Anderson SD, Godfrey S (1971) Cardio-respiratory response to treadmill exercise in normal children. Clin Sci 40(5):433–442
Bar-Or O, Shephard RJ, Allen CL (1971) Cardiac output of 10- to 13-year-old boys and girls during submaximal exercise. J Appl Physiol 30(2):219–223
Binkhorst R, De Jong-van de ker MC, Vissers ACA (1984) Growth and aerobic power of boys aged 11–19 years. In: Children and sport. Heidelberg, Springfield, pp 99–105
Binkhorst R, Saris WHM, Noordeloos AM, Van’t Hof MA (1986) Maximal oxygen consumption of children (6 to 18 years) predicted from maximal and submaximal values in treadmill and bicycle tests. In: Children and exercise. XII. Human kinetics. Champaign, IL, pp 227–232
Bouchard C, Malina RM, Hollmann W, et al. (1977) Submaximal working capacity, heart size and body size in boys 8–18 years. Eur J Appl Physiol Occup Physiol 36(2):115–126
Cooper DM, Weiler-Ravell D, Whipp BJ, et al. (1984) Growth-related changes in oxygen uptake and heart rate during progressive exercise in children. Pediatr Res 18(9):845–851
Cunningham DA, Paterson DH, Blimkie CJ, et al. (1984) Development of cardiorespiratory function in circumpubertal boys: a longitudinal study. J Appl Physiol 56(2):302–307
Krahenbuhl GS, Skinner JS, Kohrt WM (1985) Developmental aspects of maximal aerobic power in children. Exerc Sport Sci Rev 13:503–538
Nair RR, Nair P (2001) Age-dependent variation in contractility of adult cardiac myocytes. Int J Biochem Cell Biol 33(2):119–125
Noonan V, Dean E (2000) Submaximal exercise testing: clinical application and interpretation. Phys Ther 80(8):782–807
Reybrouck T, Weymans M, Stijns H, et al. (1986) Ventilatory anaerobic threshold for evaluating exercise performance in children with congenital left-to-right intracardiac shunt. Pediatr Cardiol 7(1):19–24
Schaffartzik W, Barton ED, Poole DC, et al. (1993) Effect of reduced hemoglobin concentration on leg oxygen uptake during maximal exercise in humans. J Appl Physiol 75(2):491–498, discussion 489–490
Singh TP, Wolfe RR, Sullivan NM, et al. (2001) Assessment of progressive changes in exercise performance in patients with a systemic right ventricle following the atrial switch repair. Pediatr Cardiol 22(3):210–214
Sprynarova S (1974) Longitudinal study of the influence of different physical activity programs on functional capacity of the boys from 11 to 18 years. Acta Paediatr Belg 28 (Suppl):204–213
Whipp BJ, Higgenbotham MB, Cobb FC (1996) Estimating exercise stroke volume from asymptotic oxygen pulse in humans. J Appl Physiol 81(6):2674–2679
Acknowledgments
We thank Nancy Sullivan, MS, and Roxanne Smith, CCVT, for their technical expertise in performing the exercise tests.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Chintala, K., Epstein, M.L. & Singh, T.P. Longitudinal Changes in Heart Rate-Corrected Measures of Exercise Performance in Children. Pediatr Cardiol 29, 60–64 (2008). https://doi.org/10.1007/s00246-007-9046-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-007-9046-6