Treadmill exercise test in children with cardiomyopathy and postmyocarditic myocardial hypertrophy

Indicações do teste ergométrico em crianças e adolescentes

O teste ergométrico (TE) é um procedimento de baixo risco e com complicações extremamente raras, principalmente na população pediátrica. Nesta revisão são apresentadas as principais indicações do TE nas crianças e adolescentes (idade até 19 anos), como um método de avaliação diagnóstica, prognóstica e funcional em diversas situações: avaliação da capacidade física, avaliação de sintomas relacionados ao exercício, avaliação de tratamento clínico e cirúrgico em portadores de miocardiopatias, cardiopatias congênitas e valvares, asmáticos e avaliação pré-participação em programas de atividades físicas, entre outras.

Effects of diaspirin crosslinked hemoglobin infusion in treadmill-exercised swine

The hemodynamic and metabolic effects of diaspirin crosslinked hemoglobin (DCLHb) were investigated using graded treadmill exercise in swine (n = 5/group). Swine received DCLHb (10% solution, 5 ml/kg) or oncotically-matched human serum albumin (HSA, 5ml/kg). Baseline metabolic and hemodynamic data were similar. In both groups exercise increased hemodynamic parameters. Exercise increased heart rate (HR) from 139 +/- 12 to 293 +/- 28 bpm with DCLHb and from 136 +/- 13 to 314 +/- 13 bpm with HSA. Exercise increased cardiac output (CO) from 5.7 +/- 0.75 to 15.6 +/- 2.01/min in the DCLHb group and from 5.3 +/- 0.48 to 15.7 +/- 0.881/min in the HSA group. However, CO returned to baseline faster with DCLHb upon stopping exercise. The DCLHb-treated group demonstrated a significantly higher oxygen extraction during exercise (12.04 +/- 0.38 vs 9.48 +/- 0.99 ml O2/100 ml blood) and a lower oxygen delivery throughout recovery (74.6 +/- 6.6 vs 102.2 +/- 7.21 O2/min), indicating enhanced oxygen delivery during exercise in the treatment group. DCLHb infusion did not impair metabolic or hemodynamic functions. These data indicate that DCLHb may increase oxygen delivery to working tissue more efficiently than HSA during treadmill exercise in swine.