The oxygen uptake efficiency slope in children with congenital heart disease: construct and group validity

B.C. Bongers; H.J. Hulzebos; A.C. Blank; M. van Brussel; T. Takken

doi:10.1177/1741826710389390

The oxygen uptake efficiency slope in children with congenital heart disease: construct and group validity

B.C. Bongers, H.J. Hulzebos, A.C. Blank, M. van Brussel, T. Takken^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective: The oxygen uptake efficiency slope (OUES) has been proposed as an independent and objective alternative to the peak oxygen uptake (VO2peak), which does not require maximal exercise. The aim of this study was to investigate the construct and group validity of the OUES in children with congenital heart disease (CHD).

Methods: Thirty-one patients with CHD, of which 16 patients (mean age +/- SD 11.2 +/- 2.7 years) with a Fontan repair and 15 patients (mean age +/- SD 13.2 +/- 3.6 years) with surgical repair of tetralogy of Fallot (ToF) completed a symptom-limited cardiopulmonary exercise test. The OUES was calculated and normalized for body surface area at three different exercise intensities: (1) using 100% of the exercise data; (2) using the first 75% of the exercise data; and (3) using exercise data up to the ventilatory threshold (VT). Furthermore, peak oxygen uptake (VO2peak), VT, ventilatory efficiency (V-E/VO2-slope), and ventilatory drive (V-E/VCO2-slope) were calculated and compared with values of 46 healthy children (mean age +/- SD 12.2 +/- 2.4 years).

Results: In all three groups, the OUES values determined at the three different exercise intensities were not significantly different from each other. Moreover, the OUES was significantly reduced in the children with CHD, with significantly lower values in the Fontan patients compared to ToF. Strong correlations were found between the OUES and both the VO2peak and VT in Fontan and ToF patients.

Discussion: The OUES provides a valid measure of cardiopulmonary fitness in children with CHD, which is independent of exercise intensity and strongly correlated with VO2peak and VT (construct validity). Furthermore, the OUES is capable of differentiating between healthy children and children with CHD and between Fontan and ToF patients (group validity). Therefore, the OUES may be a valid, effort-independent parameter of cardiopulmonary fitness in children with CHD.

Original language	English
Pages (from-to)	384-392
Number of pages	9
Journal	European Journal of Cardiovascular Prevention and Rehabilitation
Volume	18
Issue number	3
DOIs	https://doi.org/10.1177/1741826710389390
Publication status	Published - Jun 2011

Keywords

Oxygen uptake efficiency slope
congenital heart disease
exercise testing
children
CORONARY-ARTERY-DISEASE
CARDIORESPIRATORY FUNCTIONAL RESERVE
EXERCISE CAPACITY
CARDIAC PATIENTS
LUNG-FUNCTION
GAS-EXCHANGE
FAILURE
INDEX
PERFORMANCE
FITNESS

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10.1177/1741826710389390

http://cpr.sagepub.com/content/18/3/384.long

Cite this

@article{0f242c33825c4ffe9d917f24ac80b2fb,

title = "The oxygen uptake efficiency slope in children with congenital heart disease: construct and group validity",

abstract = "Objective: The oxygen uptake efficiency slope (OUES) has been proposed as an independent and objective alternative to the peak oxygen uptake (VO2peak), which does not require maximal exercise. The aim of this study was to investigate the construct and group validity of the OUES in children with congenital heart disease (CHD).Methods: Thirty-one patients with CHD, of which 16 patients (mean age +/- SD 11.2 +/- 2.7 years) with a Fontan repair and 15 patients (mean age +/- SD 13.2 +/- 3.6 years) with surgical repair of tetralogy of Fallot (ToF) completed a symptom-limited cardiopulmonary exercise test. The OUES was calculated and normalized for body surface area at three different exercise intensities: (1) using 100% of the exercise data; (2) using the first 75% of the exercise data; and (3) using exercise data up to the ventilatory threshold (VT). Furthermore, peak oxygen uptake (VO2peak), VT, ventilatory efficiency (V-E/VO2-slope), and ventilatory drive (V-E/VCO2-slope) were calculated and compared with values of 46 healthy children (mean age +/- SD 12.2 +/- 2.4 years).Results: In all three groups, the OUES values determined at the three different exercise intensities were not significantly different from each other. Moreover, the OUES was significantly reduced in the children with CHD, with significantly lower values in the Fontan patients compared to ToF. Strong correlations were found between the OUES and both the VO2peak and VT in Fontan and ToF patients.Discussion: The OUES provides a valid measure of cardiopulmonary fitness in children with CHD, which is independent of exercise intensity and strongly correlated with VO2peak and VT (construct validity). Furthermore, the OUES is capable of differentiating between healthy children and children with CHD and between Fontan and ToF patients (group validity). Therefore, the OUES may be a valid, effort-independent parameter of cardiopulmonary fitness in children with CHD.",

keywords = "Oxygen uptake efficiency slope, congenital heart disease, exercise testing, children, CORONARY-ARTERY-DISEASE, CARDIORESPIRATORY FUNCTIONAL RESERVE, EXERCISE CAPACITY, CARDIAC PATIENTS, LUNG-FUNCTION, GAS-EXCHANGE, FAILURE, INDEX, PERFORMANCE, FITNESS",

author = "B.C. Bongers and H.J. Hulzebos and A.C. Blank and {van Brussel}, M. and T. Takken",

year = "2011",

month = jun,

doi = "10.1177/1741826710389390",

language = "English",

volume = "18",

pages = "384--392",

journal = "European Journal of Cardiovascular Prevention and Rehabilitation",

issn = "1741-8267",

publisher = "SAGE Publications Inc.",

number = "3",

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TY - JOUR

T1 - The oxygen uptake efficiency slope in children with congenital heart disease

T2 - construct and group validity

AU - Bongers, B.C.

AU - Hulzebos, H.J.

AU - Blank, A.C.

AU - van Brussel, M.

AU - Takken, T.

PY - 2011/6

Y1 - 2011/6

N2 - Objective: The oxygen uptake efficiency slope (OUES) has been proposed as an independent and objective alternative to the peak oxygen uptake (VO2peak), which does not require maximal exercise. The aim of this study was to investigate the construct and group validity of the OUES in children with congenital heart disease (CHD).Methods: Thirty-one patients with CHD, of which 16 patients (mean age +/- SD 11.2 +/- 2.7 years) with a Fontan repair and 15 patients (mean age +/- SD 13.2 +/- 3.6 years) with surgical repair of tetralogy of Fallot (ToF) completed a symptom-limited cardiopulmonary exercise test. The OUES was calculated and normalized for body surface area at three different exercise intensities: (1) using 100% of the exercise data; (2) using the first 75% of the exercise data; and (3) using exercise data up to the ventilatory threshold (VT). Furthermore, peak oxygen uptake (VO2peak), VT, ventilatory efficiency (V-E/VO2-slope), and ventilatory drive (V-E/VCO2-slope) were calculated and compared with values of 46 healthy children (mean age +/- SD 12.2 +/- 2.4 years).Results: In all three groups, the OUES values determined at the three different exercise intensities were not significantly different from each other. Moreover, the OUES was significantly reduced in the children with CHD, with significantly lower values in the Fontan patients compared to ToF. Strong correlations were found between the OUES and both the VO2peak and VT in Fontan and ToF patients.Discussion: The OUES provides a valid measure of cardiopulmonary fitness in children with CHD, which is independent of exercise intensity and strongly correlated with VO2peak and VT (construct validity). Furthermore, the OUES is capable of differentiating between healthy children and children with CHD and between Fontan and ToF patients (group validity). Therefore, the OUES may be a valid, effort-independent parameter of cardiopulmonary fitness in children with CHD.

AB - Objective: The oxygen uptake efficiency slope (OUES) has been proposed as an independent and objective alternative to the peak oxygen uptake (VO2peak), which does not require maximal exercise. The aim of this study was to investigate the construct and group validity of the OUES in children with congenital heart disease (CHD).Methods: Thirty-one patients with CHD, of which 16 patients (mean age +/- SD 11.2 +/- 2.7 years) with a Fontan repair and 15 patients (mean age +/- SD 13.2 +/- 3.6 years) with surgical repair of tetralogy of Fallot (ToF) completed a symptom-limited cardiopulmonary exercise test. The OUES was calculated and normalized for body surface area at three different exercise intensities: (1) using 100% of the exercise data; (2) using the first 75% of the exercise data; and (3) using exercise data up to the ventilatory threshold (VT). Furthermore, peak oxygen uptake (VO2peak), VT, ventilatory efficiency (V-E/VO2-slope), and ventilatory drive (V-E/VCO2-slope) were calculated and compared with values of 46 healthy children (mean age +/- SD 12.2 +/- 2.4 years).Results: In all three groups, the OUES values determined at the three different exercise intensities were not significantly different from each other. Moreover, the OUES was significantly reduced in the children with CHD, with significantly lower values in the Fontan patients compared to ToF. Strong correlations were found between the OUES and both the VO2peak and VT in Fontan and ToF patients.Discussion: The OUES provides a valid measure of cardiopulmonary fitness in children with CHD, which is independent of exercise intensity and strongly correlated with VO2peak and VT (construct validity). Furthermore, the OUES is capable of differentiating between healthy children and children with CHD and between Fontan and ToF patients (group validity). Therefore, the OUES may be a valid, effort-independent parameter of cardiopulmonary fitness in children with CHD.

KW - Oxygen uptake efficiency slope

KW - congenital heart disease

KW - exercise testing

KW - children

KW - CORONARY-ARTERY-DISEASE

KW - CARDIORESPIRATORY FUNCTIONAL RESERVE

KW - EXERCISE CAPACITY

KW - CARDIAC PATIENTS

KW - LUNG-FUNCTION

KW - GAS-EXCHANGE

KW - FAILURE

KW - INDEX

KW - PERFORMANCE

KW - FITNESS

U2 - 10.1177/1741826710389390

DO - 10.1177/1741826710389390

M3 - Article

C2 - 21450644

SN - 1741-8267

VL - 18

SP - 384

EP - 392

JO - European Journal of Cardiovascular Prevention and Rehabilitation

JF - European Journal of Cardiovascular Prevention and Rehabilitation

IS - 3

ER -

The oxygen uptake efficiency slope in children with congenital heart disease: construct and group validity

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Keywords

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