The Generation R Study Group, Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Pediatr Cardiol. 2020 Dec;41(8):1739-1755. doi: 10.1007/s00246-020-02436-6. Epub 2020 Sep 2.
Stress inducement by physical exercise requires major cardiovascular adaptations in both adults and children to maintain an adequate perfusion of the body. As physical exercise causes a stress situation for the cardiovascular system, cardiovascular exercise stress tests are widely used in clinical practice to reveal subtle cardiovascular pathology in adult and childhood populations with cardiac and cardiovascular diseases. Recently, evidence from small studies suggests that the cardiovascular stress response can also be used within research settings to provide novel insights on subtle differences in cardiovascular health in non-diseased adults and children, as even among healthy populations an abnormal response to physical exercise is associated with an increased risk of cardiovascular diseases. This narrative review is specifically focused on the possibilities of using the cardiovascular stress response to exercise combined with advanced imaging techniques in pediatric population-based studies focused on the early origins of cardiovascular diseases. We discuss the physiology of the cardiovascular stress response to exercise, the type of physical exercise used to induce the cardiovascular stress response in combination with advanced imaging techniques, the obtained measurements with advanced imaging techniques during the cardiovascular exercise stress test and their associations with cardiovascular health outcomes. Finally, we discuss the potential for cardiovascular exercise stress tests to use in pediatric population-based studies focused on the early origins of cardiovascular diseases.
体育锻炼引起的应激需要成年人和儿童的主要心血管适应，以维持身体的充分灌注。由于体育锻炼对心血管系统造成应激，心血管运动应激试验在临床实践中被广泛用于揭示有心脏和心血管疾病的成年和儿童人群中的细微心血管病理学。最近，来自小型研究的证据表明，心血管应激反应也可以在研究环境中使用，为非患病成年人和儿童的心血管健康细微差异提供新的见解，因为即使在健康人群中，对体育锻炼的异常反应也与心血管疾病风险增加相关。本叙述性综述专门侧重于在以心血管疾病的早期起源为重点的儿科人群研究中，使用运动结合先进的成像技术来利用心血管应激反应的可能性。我们讨论了运动引起的心血管应激反应的生理学，用于结合先进的成像技术来诱导心血管应激反应的运动类型，在心血管运动应激试验期间使用先进成像技术获得的测量值及其与心血管健康结果的关联。最后，我们讨论了在以心血管疾病的早期起源为重点的儿科人群研究中使用心血管运动应激试验的潜力。
