Related Experiment Videos
Cardiac performance in children with pectus excavatum
1Department of Pediatric Surgery, Children's Hospital Medical Center, Cincinnati, OH 45229.
Insights
Children with pectus excavatum show normal exercise tolerance. However, older children with pectus excavatum exhibit elevated diastolic blood pressure and shortened cardiac systolic intervals during exercise.
Area of Science:
- Cardiology
- Pediatric Medicine
- Exercise Physiology
Background:
- Pectus excavatum is a congenital chest wall deformity.
- Its impact on pediatric exercise physiology requires further investigation.
Purpose of the Study:
- To evaluate exercise tolerance and cardiovascular responses in children with pectus excavatum.
- To identify age-related differences in these responses.
Main Methods:
- Graded exercise testing using a cycle ergometer and the James protocol.
- Comparison of maximal workload, oxygen consumption, cardiac output, and stroke volume.
- Measurement of diastolic blood pressure and left ventricular systolic time intervals (P/L ratio, PEP).
Main Results:
- No significant differences in maximal workload, oxygen consumption, cardiac output, or stroke volume between pectus excavatum and control groups.
- Significantly elevated maximal diastolic blood pressure in older pectus patients (PII).
- Significantly shortened P/L ratio and PEP in older pectus patients post-exercise.
Conclusions:
- Children with pectus excavatum generally have normal exercise tolerance and oxygen transport.
- Older children with pectus excavatum demonstrate altered cardiovascular responses to exercise, including increased diastolic blood pressure and shortened systolic intervals.
Abstract:
Fourteen children with pectus excavatum and 14 normal control patients underwent graded exercise testing using a cycle ergometer and the James protocol. All the subjects were preoperative. The children were exercised to exhaustion during the test. The pectus and control groups were broken down into subgroups consisting of subjects less than or equal to 10 years of age and subjects greater than or equal to 11 years of age (pectus and controls less than or equal to 10 years old, PI and CI, respectively; pectus and controls greater than or equal to 11 years old, PII and CII, respectively). Maximal workload, oxygen consumption, cardiac output, and stroke volume were not significantly different when comparing the total groups or when each of the respective subgroups were compared. However, maximal diastolic BP was significantly elevated when the entire pectus and control groups were compared. When the subgroups were compared, maximal diastolic BP was elevated only in the older pectus patients (PII) and remained so until five minutes after exercise. Additionally, left ventricular systolic time intervals were measured immediately after exercise in all the children. The ratio of preejection period to left ventricular ejection time (P/L) was significantly shortened in the total pectus group. When the subgroups were compared, the P/L ratio was significantly decreased only in the older patients. Also, the preejection period (PEP) was significantly shortened in the older pectus patients. It appears that children with pectus excavatum have a normal exercise tolerance and oxygen transport. However, older pectus children develop an increased diastolic BP and a shortened P/L and PEP in response to exercise.(ABSTRACT TRUNCATED AT 250 WORDS)