Table 10. Key specific indications for CPET in children and adolescents.
| Indication | Class of recommendation | Level of evidence |
|---|---|---|
| Assessment of cardiorespiratory fitness. 176 , 179 | I | A |
| Adjustment of aerobic training intensity in competitive athletes. 63 , 149 , 177 , 180 , 181 | I | A |
| Medical clearance for and prescription of exercises within the context of a cardiovascular rehabilitation program. 141 , 182 – 184 | I | A |
| Selection of candidates for heart transplantation. * 185 , 186 | I | A |
| Assessment of exercise-induced dyspnea or asthma. 178 , 179 , 187 , 188 | I | B |
| Cyanotic CHD. ** 81 , 100 , 189 | I | B |
| Follow-up after heart transplantation. ** 190 – 192 | I | B |
| In stable Kawasaki disease and Takayasu arteritis, for assessment of cardiorespiratory fitness and medical clearance/exercise prescription, including cardiovascular rehabilitation. 15 , 17 , 18 , 193 | I | C |
| Asymptomatic right-to-left shunt. ** 184 , 194 , 195 | IIa | A |
| Pulmonary arterial hypertension. ** 169 , 196 – 198 | IIa | A |
| Patients with asymptomatic moderate to severe regurgitant valve lesions. ** 81 , 199 , 200 | IIa | B |
| Patients with asymptomatic severe aortic stenosis. ** 81 , 199 , 200 | IIa | B |
| In cystic fibrosis, for assessment of cardiorespiratory fitness and prognosis. 67 , 201 , 202 | IIa | B |
| In neuromuscular diseases (multiple sclerosis, Becker and Duchenne muscular dystrophy), for assessment of cardiorespiratory fitness and exercise prescription within the context of rehabilitation. 203 – 206 | IIa | B |
| Patients with asymptomatic moderate hypertrophic obstructive cardiomyopathy. ** 207 – 209 | IIa | B |
| In patients undergoing anticancer therapy, for assessment of suspected cardiotoxicity, risk stratification, and medical clearance/exercise prescription. 104 , 174 , 175 , 210 | IIa | B |
| Mild to moderate obstructive right heart lesions. ** 81 , 199 , 211 | IIb | B |
| After surgical correction of CHD, in asymptomatic, hemodynamically stable patients. ** 212 , 213 | IIb | B |
CHD: congenital heart disease.
*
In individuals with the age, body size, ability to understand and adapt/collaborate that are essential for the correct performance of the exam.
**
For assessment of cardiorespiratory fitness, therapeutic decision-making, and determination of prognosis.