Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation

Abstract

Cardiopulmonary exercise testing (CPET) in paediatric cardiology differs in many aspects from the tests performed in adult cardiology. Children's cardiovascular responses during exercise testing present different characteristics, particularly oxygen uptake, heart rate and blood pressure response, which are essential in interpreting haemodynamic data. Diseases that are associated with myocardial ischaemia are rare in children. The main indications for CPET in children are evaluation of exercise capacity and the identification of exercise-induced arrhythmias. In this article we will review the main indications for CPET in children with congenital heart disease, the contraindications for exercise testing and the indications for terminating an exercise test. Moreover, we will address the interpretation of gas exchange data from CPET in children with congenital heart disease. (Neth Heart J 2009;17:385-92.).

Keywords: children; ergometry; exercise physiology; exercise test; oxygen uptake.

Figure 1

Algorithm for interpretation of CPET data in adults. For an explanation of the interpretation see tables 3 and 4. Modified from Eschenbacher and Mannina. VE=Ventilator equivalent for carbon dioxide; SaO₂=change in arterial saturation; IS=Ischemic Symptoms; HRR=Heart Rate Response; VT%=Ratio of VT to predicted VO_2peak.