Key result
Cardiopulmonary exercise testing 4–12 months post-MIS-C revealed lower-than-expected exercise capacity and oxygen-pulse in 50% of patients and elevated VE/VCO2-slope in 95% despite normal resting cardiac exams.
Why the study?
Multisystem inflammatory syndrome in children (MIS-C) is a serious condition requiring long-term follow-up, but the utility of cardiopulmonary exercise testing in this setting needed evaluation.
Does cardiopulmonary exercise testing (CPET) identify residual functional limitations or cardiopulmonary anomalies in children and young adolescents 4 to 12 months after hospitalization for MIS-C?
Observational (n=20)
No
Does cardiopulmonary exercise testing (CPET) identify residual functional limitations or cardiopulmonary anomalies in children and young adolescents 4 to 12 months after hospitalization for MIS-C?
Answers are grounded in this paper and cite their sources.
Cardiopulmonary exercise testing detects high rates of reduced exercise tolerance and ventilatory inefficiency 4–12 months after MIS-C despite normal resting cardiac and respiratory evaluations, supporting its utility in post-MIS-C follow-up.
Multisystem inflammatory syndrome in children (MIS-C) is a serious health condition that imposes a long-term follow-up. The purpose of our pilot study is to evaluate the usefulness of the cardiopulmonary stress test (CPET) in the follow-up after MIS-C. All patients admitted for MIS-C in our hospital in the 12 months preceding the date of observation were considered for inclusion in the study. Pre-existing cardio-respiratory diseases and/or the lack of collaboration were the exclusion criteria. At enrolment, each subject passed a cardiological examination, rest ECG, echocardiogram, 24 h Holter-ECG, blood tests, and a CPET complete of spirometry. A total of 20 patients met the inclusion criteria (11.76 ± 3.29 years, 13 male). In contrast to the normality of all second-level investigations, CPET showed lower-than-expected peakVO2 and peak-oxygen-pulse values (50% of cases) and higher-than-expected VE/VCO2-slope values (95% of cases). A statistically significant inverse correlation was observed between P-reactive-protein values at admission and peakVO2/kg values (p = 0.034), uric acid values at admission, and peakVO2 (p = 0.011) or peak-oxygen-pulse expressed as a percentage of predicted (p = 0.021), NT-proBNP values at admission and peakVO2 expressed as a percentage of predicted (p = 0.046). After MIS-C (4–12 months) relevant anomalies can be observed at CPET, which can be a valuable tool in the follow-up after this condition.
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Gentili et al. (2023) conducted an observational in Multisystem inflammatory syndrome in children (MIS-C) related to COVID-19 (n=20). Cardiopulmonary exercise testing (CPET) after hospitalization for MIS-C vs. Paediatric predicted reference values (Burstein, Dilbert, Takken, and Blunchard) was evaluated on Cardiopulmonary exercise testing parameters: higher-than-expected VE/VCO2-slope values and lower-than-expected peak VO2 and peak-oxygen-pulse values. Cardiopulmonary exercise testing 4–12 months post-MIS-C revealed lower-than-expected exercise capacity and oxygen-pulse in 50% of patients and elevated VE/VCO2-slope in 95% despite normal resting cardiac exams.
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