New Standards for the Bruce Treadmill Protocol in Children and Adolescents

We have developed normal standards for the Bruce exercise (EX) protocol since a review of 875 studies in patients with congenital or acquired heart disease showed that only 5.1% achieved the predicted 50th percentile for EX time of the standards reported by Cumming, Everatt, and Hastman (Am. J Cardiol 41:69, 1978). Our data are based on 160 males and 103 females, age 4–18 years who met the following criteria: trivial or no heart disease, maximal effort, maximal EX heart rate (HR) > 180 beats/min, and normal resting and EX ECG without arrhythmia. The ECG was monitored continuously and HR computed from the ECG and the end of each minute of EX. Comparison with the predicted data of Cumming et al. for each age group by stage showed essentially identical submaximal EX heart rates but slightly lower maximal HR (–2%), which averaged 197 beats per minute in males and females. EX times were on average 15% lower than the predicted 50th percentile for most age groups in males and females. We developed regression equations, which predict exercise time from age and body size or age, body size and 2nd stage exercise heart rate. They better reflect the capabilities of untrained, asymptomatic children and adolescents seen in our laboratory in the 1990s than the Canadian data of 1978.

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Blood pressure and resting heart rate in 3-17-year-olds in Germany in 2003–2006 and 2014–2017

Journal of Human Hypertension ◽

10.1038/s41371-021-00535-2 ◽

2021 ◽

Author(s):

Giselle Sarganas ◽

Anja Schienkiewitz ◽

Jonas D. Finger ◽

Hannelore K. Neuhauser

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Children And Adolescents ◽

Selection Rule ◽

Age Groups ◽

Resting Heart Rate ◽

Cross Sectional ◽

National Examination ◽

School Aged Children ◽

Analysis Measurement

AbstractTo track blood pressure (BP) and resting heart rate (RHR) in children and adolescents is important due to its associations with cardiovascular outcomes in the adulthood. Therefore, the aim of this study was to examine BP and RHR over a decade among children and adolescents living in Germany using national examination data. Cross-sectional data from 3- to 17-year-old national survey participants (KiGGS 2003–06, n = 14,701; KiGGS 2014–17, n = 3509) including standardized oscillometric BP and RHR were used for age- and sex-standardized analysis. Measurement protocols were identical with the exception of the cuff selection rule, which was accounted for in the analyses. Different BP and RHR trends were observed according to age-groups. In 3- to 6-year-olds adjusted mean SBP and DBP were significantly higher in 2014–2017 compared to 2003–2006 (+2.4 and +1.9 mm Hg, respectively), while RHR was statistically significantly lower by −3.8 bpm. No significant changes in BP or in RHR were observed in 7- to 10-year-olds over time. In 11- to 13-year-olds as well as in 14- to 17-year-olds lower BP has been observed (SBP −2.4 and −3.2 mm Hg, respectively, and DBP −1.8 and −1.7 mm Hg), while RHR was significantly higher (+2.7 and +3.7 bpm). BP trends did not parallel RHR trends. The downward BP trend in adolescents seemed to follow decreasing adult BP trends in middle and high-income countries. The increase in BP in younger children needs confirmation from other studies as well as further investigation. In school-aged children and adolescents, the increased RHR trend may indicate decreased physical fitness.

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Comprehensive dental evaluation of children with congenital or acquired heart disease

Cardiology in the Young ◽

10.1017/s1047951112001953 ◽

2012 ◽

Vol 23 (5) ◽

pp. 705-710 ◽

Cited By ~ 8

Author(s):

Kenan Cantekin ◽

Isin Cantekin ◽

Yasemin Torun

Keyword(s):

Heart Disease ◽

Children And Adolescents ◽

Oral Hygiene ◽

Cardiac Disease ◽

Heart Diseases ◽

Treatment Plan ◽

Caries Experience ◽

Univentricular Heart ◽

Healthy Children ◽

Acquired Heart Disease

AbstractObjectiveThe aims of this case–control study were to (a) compare the caries experience and oral hygiene, and (b) quantify the persistence of a delay in the dental age in children with cardiac disease and a group of healthy children.Methods and MaterialsThe study population comprised a group of 268 3- to 16-year-old children and adolescents with a cardiac disease and a group of 268 age- and sex-matched healthy children and adolescents. Specifically, the decayed, missed, and filled teeth indices, simplified oral hygiene index, and the dental ages of the two groups of children were calculated and then compared.ResultsAlthough the oral health of the children with either a congenital or an acquired heart disease was the same as that of the healthy children, there were significant differences in the decayed, missed, and filled teeth indices. Dental ages of the children with a congenital heart disease were significantly lower than those of healthy children. The findings showed that complex univentricular heart diseases had the highest negative impact on dental development (−1.1), followed by complex biventricular (−0.9), simple surgical (−0.5), and mild (−0.4) heart disease patients.ConclusionOnce thorough knowledge of the child's cardiac status is gained, a definitive dental treatment plan for the child with a cardiac disease can be established.

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Does body fat percentage predict post-exercise heart rate response in non-obese children and adolescents?

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2016-0468 ◽

2017 ◽

Vol 30 (6) ◽

pp. 629-633 ◽

Cited By ~ 3

Author(s):

Tatjana Jezdimirovic ◽

Valdemar Stajer ◽

Sasa Semeredi ◽

Julio Calleja-Gonzalez ◽

Sergej M. Ostojic

Keyword(s):

Heart Rate ◽

Children And Adolescents ◽

Body Fat ◽

Heart Rate Recovery ◽

Autonomic Regulation ◽

Exercise Heart Rate ◽

Body Fat Percentage ◽

Obese Children ◽

Fat Percentage ◽

Post Exercise

AbstractBackground:A correlation between adiposity and post-exercise autonomic regulation has been established in overweight and obese children. However, little information exists about this link in non-obese youth. The main purpose of this cross-sectional study was to describe the relationship between body fat percentage (BFP) and heart rate recovery after exercise [post-exercise heart rate (PEHR)], a marker of autonomic regulation, in normal-weight children and adolescents.Methods:We evaluated the body composition of 183 children and adolescents (age 15.0±2.3 years; 132 boys and 51 girls) who performed a maximal graded exercise test on a treadmill, with the heart rate monitored during and immediately after exercise.Results:A strong positive trend was observed in the association between BFP and PEHR (r=0.14; p=0.06). Hierarchical multiple regression revealed that our model explained 18.3% of the variance in PEHR (p=0.00), yet BFP accounted for only 0.9% of the variability in PEHR (p=0.16). The evaluation of the contribution of each independent variable revealed that only two variables made a unique statistically significant contribution to our model (p<0.01), with age contributing 38.7% to our model (p=0.00) while gender accounted for an additional 25.5% (p=0.01). Neither BFP (14.4%; p=0.16) nor cardiorespiratory endurance (5.0%, p=0.60) made a significant unique contribution to the model.Conclusions:Body fatness seems to poorly predict PEHR in our sample of non-obese children and adolescents, while non-modifiable variables (age and gender) were demonstrated as strong predictors of heart rate recovery. The low amount of body fat reported in non-obese young participants was perhaps too small to cause disturbances in autonomic nervous system regulation.

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Prediction of body weights of Nellore sheep under field condition

Indian Journal of Animal Research ◽

10.18805/ijar.6701 ◽

2015 ◽

Author(s):

M. Rani ◽

B. Ekambaram ◽

B. Punya Kumari

Keyword(s):

Body Weight ◽

Body Length ◽

Age Groups ◽

The Body ◽

Coefficient Of Determination ◽

Regression Equations ◽

Body Weights ◽

Chest Girth ◽

Males And Females ◽

Nellore Sheep

Data on 1350 Nellore sheep of 2, 4, 6 and 8-teeth age, reared under field conditions in 12 mandals of Chittoor district of Andhra Pradesh were utilized for development of prediction equations and study the phenotypic association among body measurements and body weights. The coefficients of correlation between body weight with the height at withers, chest girth, paunch girth, hip width and body length were positive and high in magnitude in both males and females in majority of the age groups studied. Step-down regression equations were fitted to predict the body weight based on biometrical measurements at different ages. The height at withers, chest girth, paunch girth, hip width and body length have contributed significantly to the expression of body weights at the majority of the ages studied. High coefficient of determination (R2) value was observed in males at 6 and 8-teeth age as 88 per cent, while in females 50 per cent at 2-teeth age.

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Investigation on the Incidence of Syncope in Children and Adolescents Aged 2–18 Years in Changsha

Frontiers in Pediatrics ◽

10.3389/fped.2021.638394 ◽

2021 ◽

Vol 9 ◽

Author(s):

Erlin Hu ◽

Xiaoyan Liu ◽

Qianqian Chen ◽

Cheng Wang

Keyword(s):

Children And Adolescents ◽

Cross Section ◽

Relevant Literature ◽

Age At Onset ◽

Age Groups ◽

Adolescent Females ◽

Preschool Age ◽

School Age ◽

Childhood Morbidity ◽

Males And Females

Objectives: Syncope is a common clinical symptom, while there are less relevant literature and targeted research on childhood morbidity. This article makes a cross-section survey on the incidence of syncope in children and adolescents aged 2–18 years in Changsha.Materials and Methods: There were 4,352 children and adolescents aged 2–18 years randomly selected from six primary and secondary schools and three kindergartens in Changsha from March 2018 to November 2018. There were 4,916 standardized questionnaires issued, and 4,352 (88.53%) valid questionnaires were recovered.Results: (1) Incidence: 17.37% of children and adolescents aged 2–18 years who had at least more than one syncope; the incidence in the adolescence (28.85%) was higher than that in the school age (8.32%) and in the preschool age (2.71%) (P < 0.01). (2) Age at onset: 13.9 ± 3.1 years old, with a peak age of 16 years. (3) Gender difference: The incidence in adolescent females was higher than that in males (31.72 vs. 26.25%, P < 0.05). In inducements, females had higher rates than males in sweltering environment (P < 0.01), whereas males had higher rates than females in urination (P < 0.05). Dizziness, nausea, sweating, and facial pallor were higher in females than in males in presyncope (P < 0.05).Conclusions: The incidence of syncope in children and adolescents aged 2–18 years in Changsha is 17.37%. The incidence of syncope is different between males and females in different age groups; there are gender differences in syncope inducements and presyncope.

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Children's, Adolescents', and Young Adults' Heart Rate Reactivity to, and Recovery from, a Brief Psychological Stressor

International Journal of Behavioral Development ◽

10.1177/016502549201500307 ◽

1992 ◽

Vol 15 (3) ◽

pp. 399-410 ◽

Cited By ~ 2

Author(s):

Christopher F. Sharpley

Keyword(s):

Heart Rate ◽

Mental Arithmetic ◽

Age Groups ◽

Heart Rate Reactivity ◽

Age Cohorts ◽

Age Related ◽

Males And Females ◽

Psychological Stressor ◽

Age And Sex ◽

Mean Heart Rate

Heart rate reactivity to a 2 minute mental arithmetic stressor delivered under timed and competitive conditions and graded for age-related difficulty was collected on 148 males and 153 females grouped into five age cohorts ranging from 7 to 20 years. Data on resting heart rate, heart rate during the stressor period, and post-stressor recovery showed significant sex (females had higher heart rates) and age effects (there was a general decrease in heart rate with age). There were no significant interactions between age and sex. Mean heart rate reactivity also showed significant variation with age, but no significant differences between males and females, nor any significant interaction between age and sex. The age effect for heart rate reactivity appeared to be a result of the oldest age group having significantly greater increases in heart rate than all other age groups.

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Cardiac Autonomic Modulation of Heart Rate Recovery in Children with Spina Bifida

International Journal of Sports Medicine ◽

10.1055/a-1393-6472 ◽

2021 ◽

Author(s):

Marisa Maia Leonardi-Figueiredo ◽

Gabriela Barroso de Queiroz Davoli ◽

Amanda Evangelista Avi ◽

Julio Cesar Crescêncio ◽

Silvia Cristina Moura-Tonello ◽

...

Keyword(s):

Heart Rate ◽

Spina Bifida ◽

Physical Fitness ◽

Children And Adolescents ◽

Heart Rate Recovery ◽

Recovery Phase ◽

Gas Analysis ◽

Exercise Heart Rate ◽

O2 Pulse ◽

Analysis System

AbstractWe aimed to analyse cardiac autonomic control by assessing the post-exercise heart rate recovery (HRR) and physical fitness in children and adolescents with spina bifida (SB), compared to participants with typical development. A total of 124 participants, 42 with spina bifida (SB group) and 82 typical developmental controls (CO group) performed the arm cranking exercise test with a gas analysis system. HRR was determined at the first (HRR_1) and second (HRR_2) minute at recovery phase. Data are shown as [mean difference (95% CI)]. The SB group showed reduced HR reserve [14.5 (7.1–22.0) bmp, P<0.01], slower HRR_1 [12.4 (7.4–17.5) bpm, P<0.01] and HRR_2 [16.3 (10.6–21.9) bpm; P<0.01], lower VO2peak [VO2peak relative: 7.3 (4.2–10.3) mL·min−1·kg−1, P<0.01; VO2peak absolute: 0.42 (0.30–0.54) L·min−1, P<0.01], and lower O2 pulse [2.5 (1.8–3.2) mL·bpm, P<0.01] and ventilatory responses [13.5 (8.8–18.1) L·min−1, P<0.01] than the CO group. VE/VO2 was not different between groups [−2.82 (−5.77– −0.12); P=0.06], but the VE/VCO2 [−2.59 (−4.40–0.78); P<0.01] and the values of the anaerobic threshold corrected by body mass [−3.2 (−5.8– −0.6) mL·min−1·kg−1, P=0.01] were higher in the SB group than in the CO group. We concluded that children and adolescents with SB have reduced physical fitness and a slower HRR response after maximal effort.

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Reference equations for parameters of impulse oscillometry in Egyptian children and adolescents

Egyptian Journal of Bronchology ◽

10.1186/s43168-020-00037-8 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Sally Raafat Ishak ◽

Azza Mohammed Hassan

Keyword(s):

Body Mass Index ◽

Resonant Frequency ◽

Children And Adolescents ◽

Regression Equation ◽

Regression Equations ◽

Impulse Oscillometry ◽

Predictive Values ◽

Egyptian Children ◽

Reference Equations ◽

Males And Females

Abstract Background Impulse oscillometry (IOS) is important in diagnosing respiratory functions in non-cooperative children. Studies are rising nowadays to establish reliable reference values of IOS for children of different ethnicities. No available data about the regression equations for parameters of IOS for Egyptian children and adolescents. So, our study aimed to develop regression equations for parameters of IOS in Egyptian children and adolescents in relation to their age, weight, height, and body mass index. Results Height and age affected the regression equation of impedance at 5 Hz (Z5 Hz) and resistance at 5 Hz (R5 Hz) in both males and females, resistance at 20 Hz (R20 Hz) in males and reactance at 5 Hz (X5 Hz) in females. Height affected the regression equation of R20 Hz in females, resonant frequency (Fres) in males, and the area of reactance (AX) in both males and females. While age affected the equation of X5 Hz in males and Fres in males. Conclusions Height and age were the most predictive values affecting the regression equation of IOS in Egyptian children and adolescents.

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