{"title":"运动训练改善体位性心动过速综合征青少年的循环动力学。","authors":"Yoshitoki Yanagimoto, Yuko Ishizaki, Toshiki Terashima, Ryuhei Yoshida, Kento Ishitani, Kohei Haraguchi, Mana Yamamoto, Mayumi Kubota, Yuto Adomi, Shinobu Yamasaki, Toshimitsu Suga, Kazunari Kaneko","doi":"10.3389/fped.2025.1573842","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Exercise training is recommended for PoTS; however, very few studies have examined the effectiveness of exercise training in young adolescents with PoTS. We evaluated the effects of ergometer endurance exercise on the circulatory dynamics of children with PoTS using cardiopulmonary exercise (CPX) testing, standing tests, and cardiac output monitoring.</p><p><strong>Methods: </strong>Overall, 28 participants with PoTS (19 males) aged 12-15 years were admitted to the Department of Pediatrics, Kansai Medical University General Medical Center, for 1 month between August 2020 and November 2023. Of the participants, 17 were assigned to the exercise group (13 boys) and 11 were assigned to the control group (6 boys). All participants underwent the standing test and CPX testing upon admission. The exercise group performed ergometer exercise for 30 min once per day, five times per week for 4 weeks. After 4 weeks, both groups completed the standing and CPX tests again. During the standing test, the patients underwent non-invasive hemodynamic monitoring using the AESCULON Mini®.</p><p><strong>Results: </strong>There were no significant differences between the two groups in demographic characteristics at admission (before the start of exercise training). Stroke volume, cardiac output, cardiac index, and thoracic fluid content increased after exercise training in the exercise group [pre- vs. post-exercise: cardiac output (ml) 61.7 vs. 73.1 (<i>P</i> = 0.009); cardiac output (L/min): 6.6 vs. 7.7 (<i>P</i> = 0.001); cardiac index (L/min/m<sup>2</sup>): 4.3 vs. 5.0 (<i>P</i> = 0.029); thoracic fluid content: 28.7 vs. 33.8 (<i>P</i> = 0.001)]. Exercise duration and maximal oxygen uptake (VO<sub>2</sub>) increased after exercise training in the exercise group on CPX testing [pre- vs. post-exercise: load time (min): 1.8 vs. 9.6 (<i>P</i> = 0.002), peak VO<sub>2</sub> (ml/min/kg): 30.3 vs. 33.2 (<i>P</i> = 0.005)]. The hemodynamic and CPX test results were unchanged in the control group. No significant changes were observed in orthostatic test results in either group.</p><p><strong>Discussion: </strong>Endurance exercise training for 4 weeks increased cardiac output during orthostasis in children with PoTS and inhibited the downward migration of blood. We conclude that ergometer exercise training for 4 weeks in young adolescents with PoTS may improve circulatory dynamics during orthostasis.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1573842"},"PeriodicalIF":2.1000,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176885/pdf/","citationCount":"0","resultStr":"{\"title\":\"Exercise training improves circulatory dynamics in adolescents with postural orthostatic tachycardia syndrome.\",\"authors\":\"Yoshitoki Yanagimoto, Yuko Ishizaki, Toshiki Terashima, Ryuhei Yoshida, Kento Ishitani, Kohei Haraguchi, Mana Yamamoto, Mayumi Kubota, Yuto Adomi, Shinobu Yamasaki, Toshimitsu Suga, Kazunari Kaneko\",\"doi\":\"10.3389/fped.2025.1573842\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Exercise training is recommended for PoTS; however, very few studies have examined the effectiveness of exercise training in young adolescents with PoTS. We evaluated the effects of ergometer endurance exercise on the circulatory dynamics of children with PoTS using cardiopulmonary exercise (CPX) testing, standing tests, and cardiac output monitoring.</p><p><strong>Methods: </strong>Overall, 28 participants with PoTS (19 males) aged 12-15 years were admitted to the Department of Pediatrics, Kansai Medical University General Medical Center, for 1 month between August 2020 and November 2023. Of the participants, 17 were assigned to the exercise group (13 boys) and 11 were assigned to the control group (6 boys). All participants underwent the standing test and CPX testing upon admission. The exercise group performed ergometer exercise for 30 min once per day, five times per week for 4 weeks. After 4 weeks, both groups completed the standing and CPX tests again. During the standing test, the patients underwent non-invasive hemodynamic monitoring using the AESCULON Mini®.</p><p><strong>Results: </strong>There were no significant differences between the two groups in demographic characteristics at admission (before the start of exercise training). Stroke volume, cardiac output, cardiac index, and thoracic fluid content increased after exercise training in the exercise group [pre- vs. post-exercise: cardiac output (ml) 61.7 vs. 73.1 (<i>P</i> = 0.009); cardiac output (L/min): 6.6 vs. 7.7 (<i>P</i> = 0.001); cardiac index (L/min/m<sup>2</sup>): 4.3 vs. 5.0 (<i>P</i> = 0.029); thoracic fluid content: 28.7 vs. 33.8 (<i>P</i> = 0.001)]. Exercise duration and maximal oxygen uptake (VO<sub>2</sub>) increased after exercise training in the exercise group on CPX testing [pre- vs. post-exercise: load time (min): 1.8 vs. 9.6 (<i>P</i> = 0.002), peak VO<sub>2</sub> (ml/min/kg): 30.3 vs. 33.2 (<i>P</i> = 0.005)]. The hemodynamic and CPX test results were unchanged in the control group. No significant changes were observed in orthostatic test results in either group.</p><p><strong>Discussion: </strong>Endurance exercise training for 4 weeks increased cardiac output during orthostasis in children with PoTS and inhibited the downward migration of blood. 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引用次数: 0
摘要
介绍：建议进行运动训练；然而，很少有研究调查运动训练对患有PoTS的青少年的有效性。我们通过心肺运动（CPX）测试、站立测试和心输出量监测来评估测力仪耐力运动对PoTS儿童循环动力学的影响。方法：在2020年8月至2023年11月期间，共有28名12-15岁的PoTS患者（19名男性）在关西医科大学综合医学中心儿科就诊，为期1个月。在参与者中，17人被分配到锻炼组（13名男孩），11人被分配到对照组（6名男孩）。所有参与者在入院时均进行站立测试和CPX测试。运动组每天1次，每次30分钟，每周5次，连续4周。4周后，两组再次完成站立和CPX测试。在站立试验期间，患者使用AESCULON Mini®进行无创血流动力学监测。结果：两组患者入院时（运动训练开始前）人口学特征无显著差异。运动组运动训练后卒中量、心输出量、心脏指数和胸腔液体含量增加[运动前vs.运动后：心输出量（ml） 61.7 vs. 73.1 (P = 0.009)；心输出量（L/min）： 6.6 vs. 7.7 (P = 0.001)；心脏指数（L/min/m2）： 4.3 vs. 5.0 (P = 0.029)；胸腔液体含量：28.7 vs. 33.8 (P = 0.001)]。CPX试验显示，运动组运动训练后的运动持续时间和最大摄氧量（VO2）增加[运动前与运动后：负荷时间（min）： 1.8 vs. 9.6 (P = 0.002)，峰值VO2 (ml/min/kg): 30.3 vs. 33.2 (P = 0.005)]。对照组血流动力学和CPX试验结果无明显变化。两组直立试验结果均无明显变化。讨论：耐力运动训练4周可增加PoTS患儿直立时的心排血量，抑制血液向下迁移。我们的结论是，4周的测力器运动训练可以改善站立时的循环动力学。
Exercise training improves circulatory dynamics in adolescents with postural orthostatic tachycardia syndrome.
Introduction: Exercise training is recommended for PoTS; however, very few studies have examined the effectiveness of exercise training in young adolescents with PoTS. We evaluated the effects of ergometer endurance exercise on the circulatory dynamics of children with PoTS using cardiopulmonary exercise (CPX) testing, standing tests, and cardiac output monitoring.
Methods: Overall, 28 participants with PoTS (19 males) aged 12-15 years were admitted to the Department of Pediatrics, Kansai Medical University General Medical Center, for 1 month between August 2020 and November 2023. Of the participants, 17 were assigned to the exercise group (13 boys) and 11 were assigned to the control group (6 boys). All participants underwent the standing test and CPX testing upon admission. The exercise group performed ergometer exercise for 30 min once per day, five times per week for 4 weeks. After 4 weeks, both groups completed the standing and CPX tests again. During the standing test, the patients underwent non-invasive hemodynamic monitoring using the AESCULON Mini®.
Results: There were no significant differences between the two groups in demographic characteristics at admission (before the start of exercise training). Stroke volume, cardiac output, cardiac index, and thoracic fluid content increased after exercise training in the exercise group [pre- vs. post-exercise: cardiac output (ml) 61.7 vs. 73.1 (P = 0.009); cardiac output (L/min): 6.6 vs. 7.7 (P = 0.001); cardiac index (L/min/m2): 4.3 vs. 5.0 (P = 0.029); thoracic fluid content: 28.7 vs. 33.8 (P = 0.001)]. Exercise duration and maximal oxygen uptake (VO2) increased after exercise training in the exercise group on CPX testing [pre- vs. post-exercise: load time (min): 1.8 vs. 9.6 (P = 0.002), peak VO2 (ml/min/kg): 30.3 vs. 33.2 (P = 0.005)]. The hemodynamic and CPX test results were unchanged in the control group. No significant changes were observed in orthostatic test results in either group.
Discussion: Endurance exercise training for 4 weeks increased cardiac output during orthostasis in children with PoTS and inhibited the downward migration of blood. We conclude that ergometer exercise training for 4 weeks in young adolescents with PoTS may improve circulatory dynamics during orthostasis.
期刊介绍：
Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
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