Exercise cardiac MRI AssessmentCardiopulmonary Exercise Test
Exercise cardiac MRI Assessment: Participants will undergo a standard cardiac MRI to assess resting ventricular structure and function then complete an exercise cardiac MRI assessment using an MRI-compatible stepping ergometer.
Cardiopulmonary Exercise Test: Cardiopulmonary exercise testing will be performed using a cycle ergometer. Consistent with standard guidelines, workload will progressively increase (10W ramp protocol) such that peak oxygen consumption (VO2peak) is achieved within 8-12 minutes. VO2peak, VO2 at anaerobic threshold, peak power output (PPO), ventilation/carbon dioxide production (VE/VCO2) slope, peak heart rate (HR), and HR recovery at 1- and 3-minutes will be recorded. VO2peak will be converted to age-, weight, and sex-specific norms and a %predicted value.
Study summary
There are many barriers to heart-healthy lifestyles in pediatric patients with acquired and congenital heart disease. Investigators want to further understand how participants heart and skeletal muscles work together during exercise and evaluate the impact on cardiac function. To do this, the investigators will use magnetic resonance imaging (MRI) to scan the heart and skeletal muscles during exercises to assess blood flow, oxygenation and function.
Eligibility
Sex
ALL
Min age
10 Years
Max age
18 Years
Healthy volunteers
No
Inclusion Criteria:
* 10 - 18 year olds followed at the Stollery Children's Hospital
* Heart transplant recipients ≥6 months post-transplant
* Have a moderate-complex congenital heart disease diagnosis
Exclusion Criteria:
* Non-English speaking
* Exercise restricted by the patient's clinical cardiologist
* Clinical antibody- or cellular-mediated rejection within 3-months of the assessment or during the study period (for HTRs)
* Previous involvement in a CR or exercise intervention program
* Previous exercise stress test demonstrating sustained arrhythmias, ST segment elevation or depression greater than 3mm, an inappropriate rise in blood pressure (BP) (\<20 mmHg) or a systolic BP \>200 mmHg, or symptoms of chest pain or syncope
* Resting arterial saturation \<85% or oxygen requirements
* Moderate ventricular systolic dysfunction (or worse) at the most recent echocardiogram
* History of chest pain on exertion; unrepaired/unpalliated CHD
* Arrhythmias in the last year (including supraventricular tachycardia, ventricular tachycardia, atrioventricular block or history of (Mobitz II or worse))
* New York Heart Association class II or worse symptoms
* Active medical inter-current illness limiting ability to participate
* Cognitive impairment limiting the communication needed for the exercise MRI
* Research MRI contraindications (e.g. any type of pacemaker), or any orthopedic limitation preventing exercise testing
* Extracardiac or congenital abnormality limiting the participant's functional ability to exercise
* Pregnant
Primary outcome measure(s)
MRI assessment of cardiac structure at rest — Baseline Participants will undergo a standard cardiac MRI using a Siemens MAGNETOM Prisma 3.0T CMR (Siemens Healthineers, Erlangen, Germany) for the assessment of resting ventricular structure.
MRI assessment of cardiac function at rest — Baseline Participants will undergo a standard cardiac MRI using a Siemens MAGNETOM Prisma 3.0T CMR (Siemens Healthineers, Erlangen, Germany) for the assessment of resting ventricular function.
Maximal exercise MRI assessment of cardiac structure — Baseline Participants will undergo an exercise cardiac MRI assessment using an MRI-compatible stepping ergometer (Cardio Step Module, Ergospect) to assess cardiac output.
Cardioplumonary Exercise Test — Baseline Participants will undergo a cardiopulmonary exercise test using a cycle ergometer to assess VO2peak.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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