[P31-2] 小児正常構造心のトレッドミル運動負荷試験における血圧反応
Keywords:Blood pressure response, treadmill exercise test, children with normal heart
Background: Blood pressure (BP) response to the treadmill cardiopulmonary exercise test (CPET) has yet been studied with no standard criteria for abnormal BP responses in children. Objectives: The objective of our study was to describe the BP responses to the treadmill CPET and propose the criteria for abnormal BP responses in children.Methods: Treadmill CPET data of children＜18 years with normal hearts were retrospectively analyzed to evaluate BP responses to exercise at the Children’s Hospital of Michigan over 8 years (2011－2018).Result: Our cohort included 1085 children (boys, 59%) aged 7－17 years. Analysis of variance for systolic BP at peak exercise (peak SBP) and SBP change (Δ) showed significant age and sex effects and age－sex interaction effects (p＜0.01). In the multiple linear regression model(p＜0.001, R square 0.298, standard error of the estimate 17.15), peak SBP (mmHg) was predicted as 132.27 + 1.37 × age (years) + (3.31 × age (years)－31.88) × sex [boys 1, girls 0]. The following criteria for abnormal BP responses in children were proposed: hypertensive BP response was defined by peak SBP with a 90% confidence interval upper limit of reference values based on age and sex, and blunted BP response as ΔSBP＜10 mmHg for age 7－11 years, and＜20 mmHg for boys aged 12－17 years, and ΔSBP＜10 mmHg in girls.Conclusion: BP responses to treadmill CPET depend on age and sex in children with normal hearts. The proposed criteria for abnormal BP responses should help in interpreting BP responses in children during CPET.