What is the clinical evidence from this study?

Study design: Case-Control. Population: Myocardial dysfunction risk after arterial switch operation (ASO) or Kawasaki disease (KD) (n=43). Intervention: Cardiopulmonary exercise testing combined with stress echocardiography vs. Healthy age- and sex-matched controls. Primary outcome: Peak cardiopulmonary function (VO2peak).

What does this research mean for the field?

Pediatric patients with a history of arterial switch operation or Kawasaki disease exhibit impaired cardiopulmonary function and slower O2pulse recovery during exercise, suggesting latent cardiac output impairment despite normal echocardiographic ventricular function. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to evaluate myocardial dysfunction using stress echocardiography combined with cardiopulmonary exercise testing in patients after arterial switch operation (ASO) or Kawasaki disease (KD).

May 24, 2026Pediatric Exercise Science

Arterial switch operation patients show ~14% lower peak VO2 compared to healthy controls.

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Why the study?

Stress echocardiography is rarely used in pediatric cardiology despite being established for evaluating myocardial dysfunction from coronary insufficiency after arterial switch operation or Kawasaki disease.

Does cardiopulmonary exercise testing combined with stress echocardiography identify myocardial dysfunction in pediatric patients after arterial switch operation or Kawasaki disease compared to healthy controls?

Population

43 participants (20 post-ASO, 10 post-KD, and 13 age- and sex-matched controls)

Comparison

Patients after ASO or KD vs matched healthy controls

Design

Case-control study

Key result

Cardiopulmonary exercise testing showed patients after arterial switch operation had significantly lower peak oxygen consumption compared to healthy controls (39.6 vs 45.9 mL/kg/min).

Authors

ISIsabelle Schöffl ETEva Trager LKLennart Keßler

Discussion

Member takes

Overview

Reduced peak VO2 post-ASO may signal exercise limitation; leaves open whether combined CPET-stress echo detects clinically relevant dysfunction.

Key Points

The study aims to evaluate myocardial dysfunction using stress echocardiography combined with cardiopulmonary exercise testing in patients after arterial switch operation (ASO) or Kawasaki disease (KD).
Participants included patients post-ASO and KD, with a control group of age- and sex-matched university students and school children.
Cardiopulmonary exercise testing was performed on a tilt-recline cycle ergometer or a treadmill with intermittent echocardiography.
Echocardiographic examinations focused on global longitudinal strain measurements and various cardiopulmonary parameters.
ASO patients showed significantly lower peak oxygen consumption (VO2peak: 39.6 vs 45.9 mL/kg/min) compared to controls.
KD and ASO patients had significantly lower first ventilatory threshold and decline of O2pulse during recovery than controls.
Echocardiographic parameters indicated no significant decreases, but slower recovery of O2pulse could suggest cardiac output impairment.

Study Design

Type

Case-Control (n=43)

Structured PICO

Population

43 pediatric participants including 20 after arterial switch operation (ASO) (mean age 14.7 y, 8 females), 10 after Kawasaki disease (KD) (mean age 15.0 y, 3 females), and 13 age- and sex-matched healthy controls (mean age 15.7 y, 5 females).

Intervention

Cardiopulmonary exercise testing on a tilt-recline cycle ergometer or treadmill combined with intermittent stress echocardiography (global longitudinal strain measurements).

Comparator

Age- and sex-matched healthy control group of university students and school children undergoing the same testing protocol.

Outcome

Cardiopulmonary exercise parameters (peak oxygen consumption, peak heart rate, O2pulse, oxygen uptake efficiency slope, V˙E/V˙CO2-slope, O2pulse behavior) and echocardiographic parameters (global longitudinal strain of the left ventricle).surrogate

Main Result

Absolute Event Rate: 39.6% vs 45.9%

Cardiopulmonary exercise testing reveals lower peak oxygen consumption and slower O2pulse recovery in pediatric patients after arterial switch operation or Kawasaki disease, suggesting impaired cardiac output during exercise despite normal stress echocardiography.

Cite This Study

Schöffl et al. (2026) conducted a case-control in Myocardial dysfunction risk after arterial switch operation (ASO) or Kawasaki disease (KD) (n=43). Cardiopulmonary exercise testing combined with stress echocardiography vs. Healthy age- and sex-matched controls was evaluated on Peak cardiopulmonary function (VO2peak). Cardiopulmonary exercise testing showed patients after arterial switch operation had significantly lower peak oxygen consumption compared to healthy controls (39.6 vs 45.9 mL/kg/min).

synapsesocial.com/papers/6a12953848a0ea16656715f2 https://doi.org/10.1123/pes.2025-0028

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May 24, 2026Pediatric Exercise Science

Arterial switch operation patients show ~14% lower peak VO2 compared to healthy controls.

View Full Paper

Ask AI

Bookmark

Why the study?

Population

43 participants (20 post-ASO, 10 post-KD, and 13 age- and sex-matched controls)

Comparison

Patients after ASO or KD vs matched healthy controls

Design

Case-control study

Key result

Cardiopulmonary exercise testing showed patients after arterial switch operation had significantly lower peak oxygen consumption compared to healthy controls (39.6 vs 45.9 mL/kg/min).

Authors

ISIsabelle Schöffl ETEva Trager LKLennart Keßler

Discussion

Member takes

Overview

Reduced peak VO2 post-ASO may signal exercise limitation; leaves open whether combined CPET-stress echo detects clinically relevant dysfunction.

Key Points

The study aims to evaluate myocardial dysfunction using stress echocardiography combined with cardiopulmonary exercise testing in patients after arterial switch operation (ASO) or Kawasaki disease (KD).
Participants included patients post-ASO and KD, with a control group of age- and sex-matched university students and school children.
Cardiopulmonary exercise testing was performed on a tilt-recline cycle ergometer or a treadmill with intermittent echocardiography.
Echocardiographic examinations focused on global longitudinal strain measurements and various cardiopulmonary parameters.
ASO patients showed significantly lower peak oxygen consumption (VO2peak: 39.6 vs 45.9 mL/kg/min) compared to controls.
KD and ASO patients had significantly lower first ventilatory threshold and decline of O2pulse during recovery than controls.
Echocardiographic parameters indicated no significant decreases, but slower recovery of O2pulse could suggest cardiac output impairment.

Study Design

Type

Case-Control (n=43)

Structured PICO

Population

Intervention

Cardiopulmonary exercise testing on a tilt-recline cycle ergometer or treadmill combined with intermittent stress echocardiography (global longitudinal strain measurements).

Comparator

Age- and sex-matched healthy control group of university students and school children undergoing the same testing protocol.

Outcome

Main Result

Absolute Event Rate: 39.6% vs 45.9%

Cite This Study

synapsesocial.com/papers/6a12953848a0ea16656715f2 https://doi.org/10.1123/pes.2025-0028

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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