Cardiovascular responses to a 3-minute Harvard step test in Paediatric competitive athletes

IF 3.3 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology Pub Date : 2026-04-01 Epub Date: 2025-12-13 DOI:10.1016/j.ijcard.2025.134097

Gian Luca Ragazzoni , Luna Cavigli , Alex Boncompagni , Guglielmo Leonardo Manfredi , Silvia Giangrandi , Riccardo Mei , Elisa Pucci , Sofia Capparuccia , Marta Focardi , Giulia Elena Mandoli , Maria Concetta Pastore , Cosetta Meniconi , Andrea Franchini , Massimo Capitani , Matteo Cameli , Serafina Valente , Marco Bonifazi , Flavio D'Ascenzi

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引用次数: 0

Abstract

Background

The Italian pre-participation screening (PPS) program includes a simplified 3-min step test to assess cardiovascular responses in paediatric athletes, yet limited data exist on the cardiovascular response to this test in the paediatric population.

Objectives

To evaluate heart rate (HR), blood pressure (BP), and arrhythmic responses to a step test in healthy children undergoing PPS.

Methods

We prospectively enrolled 647 athletes (mean age 13 ± 2 years, 51 % male) undergoing PPS from September 2023 to May 2024. All participants performed a 3-min step test with continuous ECG monitoring and BP measurements at rest, peak, and recovery. Subgroup analyses were performed by sex and age group. Regression analyses were used to assess predictors of HR_peak, % of predicted HR_peak and systolic BP.

Results

The mean resting HR was 81 ± 17 bpm, with HR_peak of 169 ± 14 bpm (85 % of predicted). The most significant HR increase occurred in the first minute. BP_peak remained modest (128/60 mmHg). Female athletes had higher HRs but lower BP than males (p < 0.001). Resting HR declined with age, while HR_peak remained constant across groups. BP increased with age, though only systolic BP differed at peak. Regression analysis identified resting HR, sex, and BMI as predictors of HR_peak, while weight alone predicted systolic BP_peak. Exercise-induced premature ventricular beats (PVBs) occurred in 0.46 % of athletes, all with benign morphology and no underlying structural heart disease.

Conclusions

The step test elicits a strong HR response in paediatric athletes and has a low arrhythmic yield. However, it is not suitable for assessing hypertensive responses during exercise.

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儿科竞技运动员对3分钟哈佛步进测试的心血管反应

背景：意大利参赛前筛查（PPS）项目包括一项简化的3分钟步骤测试，以评估儿科运动员的心血管反应，但关于儿科人群对该测试的心血管反应的数据有限。目的：评价接受PPS治疗的健康儿童的心率（HR）、血压（BP）和心律失常反应。方法：从2023年9月至2024年5月，我们前瞻性地招募了647名运动员（平均年龄13 ± 2 岁，男性51. %）接受PPS治疗。所有参与者都进行了3分钟的步进试验，并在休息、高峰和恢复时进行了连续的心电图监测和血压测量。按性别和年龄组进行亚组分析。采用回归分析评估峰值心率、预测HRpeak的百分比和收缩压的预测因子。结果：平均静息心率为81 ± 17 bpm，心率峰值为169 ± 14 bpm（预测的85 %）。最显著的人力资源增加发生在第一分钟。血压保持适度（128/60 mmHg）。女性运动员的hr高于男性，但血压低于男性（p 峰值在各组间保持不变）。血压随年龄增加而增加，但峰值时只有收缩压不同。回归分析发现静息心率、性别和BMI是HRpeak的预测因子，而体重单独预测收缩期心率峰值。运动诱发的室性早搏（pbs）发生率为0.46% %，所有运动员均为良性形态，无潜在的结构性心脏病。结论：步进试验在儿科运动员中引起强烈的心率反应，心律失常率低。然而，它不适合评估运动期间的高血压反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of cardiology 医学-心血管系统

CiteScore

6.80

自引率

5.70%

发文量

758

审稿时长

44 days

期刊介绍： The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers. In addition to original papers, we are launching a range of new manuscript types, including Consensus and Position Papers, Systematic Reviews, Meta-analyses, and Short communications. Case reports are no longer acceptable. Controversial techniques, issues on health policy and social medicine are discussed and serve as useful tools for encouraging debate.