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(Chest. 2001;120:816-824.)
© 2001 American College of Chest Physicians

Cardiopulmonary Exercise Testing in Children With Heart Failure Secondary to Idiopathic Dilated Cardiomyopathy*

Guilherme Veiga Guimarães, PhEd; Giovanni Bellotti, MD; Amilcar Oshiro Mocelin, MD; Paulo Roberto Camargo, MD and Edimar Alcides Bocchi, MD

* From the Heart Institute, University of São Paulo, Medical School, São Paulo, Brazil.

Correspondence to: Guilherme Veiga Guimarães, PhEd, Instituto do Coração, Rua Dr. Baeta Neves, 98–05444-050, São Paulo, SP, Brazil; e-mail: gvguima{at}usp.br

Study objective: To determine and compare the cardiopulmonary responses of healthy children and children with heart failure due to idiopathic dilated cardiomyopathy (IC) to progressive treadmill exercise testing.

Setting: University teaching hospital specializing in cardiology.

Patients or participants: Twenty-six children with stable, chronic heart failure (left ventricular ejection fraction < 45%) caused by IC (IC group) and 12 healthy children (control group).

Interventions: After 12-lead resting ECG, all children underwent progressive treadmill exercise testing using a modified Naughton protocol. Tests were performed in a controlled-temperature exercise facility, at least 2 h after a light meal.

Measurements and results: Cardiopulmonary parameters were assessed at rest, at anaerobic threshold (AT), and at peak exercise. At rest, the tidal volume (VT) and O2 consumption (O2) for heart rate (O2 pulse) were lower, while the heart rate, respiratory rate, and ventilatory equivalent for O2 (minute ventilation [E]/O2) were higher in the IC group compared with the control group. At AT, the systolic BP, O2 pulse, VT, exercise duration, O2, CO2 production (CO2), and E were lower, while the E/O2 and ventilatory equivalent for CO2 (E/CO2) were higher in the IC group (p < 0.05). At peak exercise, the IC group had a significantly lower systolic BP, O2 pulse, E, VT, exercise duration, O2, and CO2, but higher E/O2 and E/CO2 than the control group (p < 0.05). The E/CO2 slope was significantly higher for the IC group. No correlation existed between variables evaluated at rest vs during exercise.

Conclusions: Gas exchange analysis performed during exercise successfully differentiated children with heart failure from healthy children.

Key Words: children • exercise • heart failure • oxygen consumption






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