assessment of measurement properties of peak vo2 in children with pulmonary arterial hypertension评估测量峰值特性的最大儿童肺动脉高血压.pdfVIP

Cappelleri et al. BMC Pulmonary Medicine 2012, 12:54 /1471-2466/12/54 RESEARCH ARTICLE Open Access Assessment of measurement properties of peak VO2 in children with pulmonary arterial hypertension Joseph C Cappelleri1*†, Lie-Ju Hwang2†, Jack Mardekian2† and Marko A Mychaskiw3† Abstract Background: The 6-minute walk test evaluates the effect of pharmacologic intervention in adults with pulmonary arterial hypertension (PAH) but, for reasons of compliance or reliability, may not be appropriate for children at all ages. Thus, peak oxygen consumption (VO2, maximal exercise test) was used instead in a pediatric PAH trial (STARTS-1) to evaluate pharmacologic intervention with sildenafil. This was the first large placebo-controlled trial to use the peak VO2 endpoint in this population. Our working hypothesis was that, as with other populations, percentage changes in peak VO2 in pediatric patients with PAH are reliable and are associated with changes in other clinical endpoints. Methods: Using data from the subpopulation of 106 patients who were developmentally and physically able to perform exercise testing, all of whom were World Health Organization Functional Class (WHO FC) I, II, or III, reliability was assessed using the intraclass correlation coefficient and Bland-Altman plot on screening and baseline data. Relationships between percentage change in peak VO2 from baseline to end of treatment and other endpoints were evaluated using correlation coefficients and regression analyses. Results: The intraclass correlation was 0.79 between screening and baseline peak VO2, an agreement that was supported by the Bland-Altman plot. Percentage change in peak VO2 correlated well (r ≥0.40) and showed responsiveness to a physician global assessment of change and with change in WHO FC (for baseline classes I and III).