A Reference Equation for VO 2peak for Pediatric Patients Undergoing Treadmill Cardiopulmonary Exercise Testing.

Griffith GJ; Northwestern University Feinberg School of Medicine. Electronic address: garett.griffith@northwestern.edu.
Wang AP; Liem RI; Carr MR;Corson T; Ward K;

The American journal of cardiology [Am J Cardiol] 2023 Nov 30.
Date of Electronic Publication: 2023 Nov 30.

Pediatric patients are often referred to cardiopulmonary exercise testing (CPET) laboratories for assessment of exercise-related symptoms. For clinicians to understand results in the context of performance relative to peers, adequate fitness-based prediction equations must be available. However, reference equations for prediction of peak oxygen uptake (VO2peak ) in pediatrics are largely developed from field-based testing and equations derived from CPET are primarily developed using adult data. Our objective was to develop a pediatric reference equation for VO2peak .
Clinical CPET data from a validation cohort of 1,383 pediatric patients aged 6-18 years who achieved a peak RER≥1.00 were analyzed to identify clinical and exercise testing factors that contributed to the prediction of VO2peak from tests performed using the Bruce protocol.
The resultant prediction equation was applied to a cross-validation cohort of 1,367 pediatric patients. Exercise duration, sex, weight, and age contributed to the prediction of VO2peak , resulting in the following prediction equation (R 2  = 0.645, p < 0.001, SEE = 6.19mL/kg/min): VO2peak (mL/kg/min) = 16.411+ 3.423 (exercise duration [minutes]) – 5.145 (sex [0=male, 1=female]) – 0.121 (weight [kg]) + 0.179 (age [years]). This equation was stable across the age range included in the present study, with differences ≤ 0.5mL/kg/min between mean measured and predicted VO2peak in all age groups.
In conclusion, this study represents the largest pediatric CPET-derived VO2peak prediction effort to date and this VO2peak prediction equation provides clinicians who perform and interpret exercise tests on pediatric patients with a resource with which to better quantify fitness when CPET is not available.