title: Comparing four non-invasive methods to determine the ventilatory anaerobic threshold during cardiopulmonary exercise testing in children with congenital heart or lung disease.
abstract: BACKGROUND
  The ventilatory anaerobic threshold (VAT) is an important method to assess the aerobic fitness in patients with cardiopulmonary disease. Several methods exist to determine the VAT; however, there is no consensus which of these methods is the most accurate.
  
  
  OBJECTIVE
  To compare four different non-invasive methods for the determination of the VAT via respiratory gas exchange analysis during a cardiopulmonary exercise test (CPET). A secondary objective is to determine the interobserver reliability of the VAT.
  
  
  METHODS
  CPET data of 30 children diagnosed with either cystic fibrosis (CF; N = 15) or with a surgically corrected dextro-transposition of the great arteries (asoTGA; N = 15) were included.
  
  
  RESULTS
  No significant differences were found between conditions or among testers. The RER = 1 method differed the most compared to the other methods, showing significant higher results in all six variables. The PET-O2 method differed significantly on five of six and four of six exercise variables with the V-slope method and the VentEq method, respectively. The V-slope and the VentEq method differed significantly on one of six exercise variables. Ten of thirteen ICCs that were >0.80 had a 95% CI > 0.70. The RER = 1 method and the V-slope method had the highest number of significant ICCs and 95% CIs.
  
  
  CONCLUSIONS
  The V-slope method, the ventilatory equivalent method and the PET-O2 method are comparable and reliable methods to determine the VAT during CPET in children with CF or asoTGA.
authors: Child Development & Exercise Centre, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Naomi C A
authors: NC
authors: Visschers
authors: Child Development & Exercise Centre, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Erik H
authors: EH
authors: Hulzebos
authors: Child Development & Exercise Centre, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Marco
authors: M
authors: van Brussel
authors: Child Development & Exercise Centre, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.|Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, The Netherlands.
authors: Tim
authors: T
authors: Takken
mesh_terms: D000293:Adolescent; D015308:Anaerobic Threshold; D002648:Child; D002675:Child, Preschool; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: anaerobic threshold; child; congenitally corrected transposition of the great arteries; cystic fibrosis; exercise test