title: Correlation between cardio-pulmonary exercise test variables and health-related quality of life among children with congenital heart diseases.
abstract: BACKGROUND
  Health-related quality of life (HR-QoL) stands as a determinant "patient-related outcome" and correlates with cardio-pulmonary exercise test (CPET) in adults with chronic heart failure or with a congenital heart disease (CHD). No such correlation has been established in pediatric cardiology.
  
  
  RESULTS
  202 CHD children aged 8 to 18 performed a CPET (treadmill n=96, cycle-ergometer n=106). CHD severity was stratified into 4 groups. All children and parents filled out the Kidscreen HR-QoL questionnaire. Peak VO2, anaerobic threshold (AT), and oxygen pulse followed a downward significant trend with increasing CHD severity and conversely for VE/VCO2 slope. Self-reported and parent-reported physical well-being HR-QoL scores correlated with peak VO2 (respectively r=0.27, p<0.0001 and r=0.43, p<0.0001), percentage of predicted peak VO2 (r=0.28, p=0.0001 and r=0.41, p<0.0001), and percentage of predicted VO2 at AT (r=0.22, p<0.01 and r=0.31, p<0.0001). Significant correlations were also observed between several HR-QoL dimensions and dead space to tidal volume ratio (VD/VT), oxygen uptake efficiency slope (OUES), oxygen pulse but never with VE/VCO2 slope. The strongest correlations were observed in the treadmill group, especially between peak VO2 and physical well-being for parents (r=0.57, p<0.0001) and self (r=0.40, p<0.0001) reported HR-QoL.
  
  
  CONCLUSIONS
  Peak VO2 and AT are the two CPET variables that best correlated with HR-QoL in this large pediatric cohort, parents' reports being more accurate. If HR-QoL is involved as a "PRO" in a pediatric cardiology clinical trial, we suggest using parents related physical well-being HR-QoL scores.
  
  
  BACKGROUND
  ClinicalTrials.gov (number NCT01202916).
authors.affiliation: Pediatric and Congenital Cardiology Department, University Hospital, Montpellier, France; Physiology and Experimental Biology of Heart and Muscles Laboratory - PHYMEDEXP, UMR CNRS 9214 - INSERM U1046, University of Montpellier, Montpellier, France; Self-perceived Health Assessment Research Unit, EA3279, Public Health Department, Mediterranean Medical School, Marseille, France. Electronic address: p-amedro@chu-montpellier.fr.
authors.forename: P
authors.initials: P
authors.lastname: Amedro
authors.affiliation: Epidemiology and Clinical Research Department, University Hospital, Montpellier, France; Clinical Investigation Center, INSERM-CIC 1411, Montpellier, France.
authors.forename: M C
authors.initials: MC
authors.lastname: Picot
authors.affiliation: Pediatric and Congenital Cardiology Department, St-Luc University Hospital, UCL, Brussels, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Moniotte
authors.affiliation: Pediatric and Congenital Cardiology Department, University Hospital, Montpellier, France.
authors.forename: R
authors.initials: R
authors.lastname: Dorka
authors.affiliation: Pediatric and Congenital Cardiology Department, St-Luc University Hospital, UCL, Brussels, Belgium; Clinical Investigation Center, INSERM-CIC 1411, Montpellier, France.
authors.forename: H
authors.initials: H
authors.lastname: Bertet
authors.affiliation: Pediatric and Congenital Cardiology Department, University Hospital, Montpellier, France; Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France.
authors.forename: S
authors.initials: S
authors.lastname: Guillaumont
authors.affiliation: Pediatric and Congenital Cardiology Department, St-Luc University Hospital, UCL, Brussels, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Barrea
authors.affiliation: Pediatric and Congenital Cardiology Department, University Hospital, Montpellier, France; Physiology and Experimental Biology of Heart and Muscles Laboratory - PHYMEDEXP, UMR CNRS 9214 - INSERM U1046, University of Montpellier, Montpellier, France.
authors.forename: M
authors.initials: M
authors.lastname: Vincenti
authors.affiliation: Pediatric and Congenital Cardiology Department, University Hospital, Montpellier, France; Pediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France.
authors.forename: G
authors.initials: G
authors.lastname: De La Villeon
authors.affiliation: Pediatric and Congenital Cardiology Department, University Hospital, Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Bredy
authors.affiliation: Pediatric and Congenital Cardiology Department, University Hospital, Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Soulatges
authors.affiliation: Pediatric and Congenital Cardiology Department, University Hospital, Montpellier, France.
authors.forename: M
authors.initials: M
authors.lastname: Voisin
authors.affiliation: Physiology and Experimental Biology of Heart and Muscles Laboratory - PHYMEDEXP, UMR CNRS 9214 - INSERM U1046, University of Montpellier, Montpellier, France; Pediatric Functional Exploration Laboratory, Physiology Department, University Hospital, Montpellier, France.
authors.forename: S
authors.initials: S
authors.lastname: Matecki
authors.affiliation: Self-perceived Health Assessment Research Unit, EA3279, Public Health Department, Mediterranean Medical School, Marseille, France.
authors.forename: P
authors.initials: P
authors.lastname: Auquier
mesh_terms: D000293:Adolescent; D015308:Anaerobic Threshold / Q000502:physiology; D002648:Child; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005080:Exercise Test / Q000379:methods* / Q000592:standards; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D008297:Male; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D057566:Self Report; D011795:Surveys and Questionnaires
chemical_list: D010100:Oxygen
keywords: Cardio-pulmonary exercise test; Congenital heart disease; Peak VO2; Pediatrics; Quality of life