Yanagimoto Yoshitoki, Ishizaki Yuko, Terashima Toshiki, Yoshida Ryuhei, Ishitani Kento, Haraguchi Kohei, Yamamoto Mana, Kubota Mayumi, Adomi Yuto, Yamasaki Shinobu, Suga Toshimitsu, Kaneko Kazunari
Department of Pediatrics, Kansai Medical University, Osaka, Japan.
Department of Health Science Center, Kansai Medical University, Osaka, Japan.
Front Pediatr. 2025 Jun 5;13:1573842. doi: 10.3389/fped.2025.1573842. eCollection 2025.
Exercise training is recommended for PoTS; however, very few studies have examined the effectiveness of exercise training in young adolescents with PoTS. We evaluated the effects of ergometer endurance exercise on the circulatory dynamics of children with PoTS using cardiopulmonary exercise (CPX) testing, standing tests, and cardiac output monitoring.
Overall, 28 participants with PoTS (19 males) aged 12-15 years were admitted to the Department of Pediatrics, Kansai Medical University General Medical Center, for 1 month between August 2020 and November 2023. Of the participants, 17 were assigned to the exercise group (13 boys) and 11 were assigned to the control group (6 boys). All participants underwent the standing test and CPX testing upon admission. The exercise group performed ergometer exercise for 30 min once per day, five times per week for 4 weeks. After 4 weeks, both groups completed the standing and CPX tests again. During the standing test, the patients underwent non-invasive hemodynamic monitoring using the AESCULON Mini®.
There were no significant differences between the two groups in demographic characteristics at admission (before the start of exercise training). Stroke volume, cardiac output, cardiac index, and thoracic fluid content increased after exercise training in the exercise group [pre- vs. post-exercise: cardiac output (ml) 61.7 vs. 73.1 ( = 0.009); cardiac output (L/min): 6.6 vs. 7.7 ( = 0.001); cardiac index (L/min/m): 4.3 vs. 5.0 ( = 0.029); thoracic fluid content: 28.7 vs. 33.8 ( = 0.001)]. Exercise duration and maximal oxygen uptake (VO) increased after exercise training in the exercise group on CPX testing [pre- vs. post-exercise: load time (min): 1.8 vs. 9.6 ( = 0.002), peak VO (ml/min/kg): 30.3 vs. 33.2 ( = 0.005)]. The hemodynamic and CPX test results were unchanged in the control group. No significant changes were observed in orthostatic test results in either group.
Endurance exercise training for 4 weeks increased cardiac output during orthostasis in children with PoTS and inhibited the downward migration of blood. We conclude that ergometer exercise training for 4 weeks in young adolescents with PoTS may improve circulatory dynamics during orthostasis.
体位性心动过速综合征（PoTS）患者推荐进行运动训练；然而，很少有研究探讨运动训练对青少年PoTS患者的有效性。我们使用心肺运动（CPX）测试、站立测试和心输出量监测，评估了测力计耐力运动对PoTS患儿循环动力学的影响。
2020年8月至2023年11月期间，共有28名年龄在12 - 15岁的PoTS患者（19名男性）被收治于关西医科大学综合医疗中心儿科，为期1个月。其中，17名被分配至运动组（13名男孩），11名被分配至对照组（6名男孩）。所有参与者入院时均接受了站立测试和CPX测试。运动组每天进行一次30分钟的测力计运动，每周5次，共4周。4周后，两组再次完成站立和CPX测试。在站立测试期间，使用AESCULON Mini®对患者进行无创血流动力学监测。
两组入院时（运动训练开始前）的人口统计学特征无显著差异。运动组运动训练后每搏输出量、心输出量、心脏指数和胸腔液体含量增加[运动前与运动后：心输出量（毫升）61.7对73.1（=0.009）；心输出量（升/分钟）：6.6对7.7（=0.001）；心脏指数（升/分钟/米）：4.3对5.0（=0.029）；胸腔液体含量：28.7对33.8（=0.001）]。运动组在CPX测试中运动训练后运动持续时间和最大摄氧量（VO）增加[运动前与运动后：负荷时间（分钟）：1.8对9.6（=0.002），峰值VO（毫升/分钟/千克）：30.3对33.2（=0.005）]。对照组的血流动力学和CPX测试结果未改变。两组的直立位测试结果均未观察到显著变化。
为期4周的耐力运动训练增加了PoTS患儿直立位时的心输出量，并抑制了血液的向下迁移。我们得出结论，对青少年PoTS患者进行为期4周的测力计运动训练可能会改善直立位时的循环动力学。
