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Assessment of measurement properties of peak VO(2) in children with pulmonary arterial hypertension

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 (VO(2), maximal exercise test) was...

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Autores principales: Cappelleri, Joseph C, Hwang, Lie-Ju, Mardekian, Jack, Mychaskiw, Marko A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528474/
https://www.ncbi.nlm.nih.gov/pubmed/22963001
http://dx.doi.org/10.1186/1471-2466-12-54
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author Cappelleri, Joseph C
Hwang, Lie-Ju
Mardekian, Jack
Mychaskiw, Marko A
author_facet Cappelleri, Joseph C
Hwang, Lie-Ju
Mardekian, Jack
Mychaskiw, Marko A
author_sort Cappelleri, Joseph C
collection PubMed
description 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 (VO(2), 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 VO(2) endpoint in this population. Our working hypothesis was that, as with other populations, percentage changes in peak VO(2) 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 VO(2) 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 VO(2), an agreement that was supported by the Bland-Altman plot. Percentage change in peak VO(2) 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). Percentage change in peak VO(2) did not correlate with change in the Family Cohesion of the Child Health Questionnaire (r = 0.04) or with a subject global assessment of change (r = 0.12). The latter may have been influenced by child and parental-proxy response and instrument administration. CONCLUSION: In pediatric PAH patients who are developmentally and physically able to perform exercise testing, peak VO(2) measurements exhibited good reliability and improvements that were associated with improvements in certain other clinical endpoints, such as the WHO FC and a physician global assessment. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT00159913.
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spelling pubmed-35284742013-01-03 Assessment of measurement properties of peak VO(2) in children with pulmonary arterial hypertension Cappelleri, Joseph C Hwang, Lie-Ju Mardekian, Jack Mychaskiw, Marko A BMC Pulm Med Research Article 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 (VO(2), 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 VO(2) endpoint in this population. Our working hypothesis was that, as with other populations, percentage changes in peak VO(2) 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 VO(2) 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 VO(2), an agreement that was supported by the Bland-Altman plot. Percentage change in peak VO(2) 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). Percentage change in peak VO(2) did not correlate with change in the Family Cohesion of the Child Health Questionnaire (r = 0.04) or with a subject global assessment of change (r = 0.12). The latter may have been influenced by child and parental-proxy response and instrument administration. CONCLUSION: In pediatric PAH patients who are developmentally and physically able to perform exercise testing, peak VO(2) measurements exhibited good reliability and improvements that were associated with improvements in certain other clinical endpoints, such as the WHO FC and a physician global assessment. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT00159913. BioMed Central 2012-09-10 /pmc/articles/PMC3528474/ /pubmed/22963001 http://dx.doi.org/10.1186/1471-2466-12-54 Text en Copyright ©2012 Cappelleri et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Cappelleri, Joseph C
Hwang, Lie-Ju
Mardekian, Jack
Mychaskiw, Marko A
Assessment of measurement properties of peak VO(2) in children with pulmonary arterial hypertension
title Assessment of measurement properties of peak VO(2) in children with pulmonary arterial hypertension
title_full Assessment of measurement properties of peak VO(2) in children with pulmonary arterial hypertension
title_fullStr Assessment of measurement properties of peak VO(2) in children with pulmonary arterial hypertension
title_full_unstemmed Assessment of measurement properties of peak VO(2) in children with pulmonary arterial hypertension
title_short Assessment of measurement properties of peak VO(2) in children with pulmonary arterial hypertension
title_sort assessment of measurement properties of peak vo(2) in children with pulmonary arterial hypertension
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528474/
https://www.ncbi.nlm.nih.gov/pubmed/22963001
http://dx.doi.org/10.1186/1471-2466-12-54
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