摘要

Cardiovascular disease is up to 10 times more likely among childhood cancer survivors compared to siblings. Low cardiorespiratory fitness is a modifiable risk-factor for cardiovascular diseases. Yet, cardiorespiratory fitness is not routinely screened in pediatric oncology, and healthy VO2max cut-points are unavailable. We aimed to predict cardiorespiratory fitness by developing a simple algorithm and establish cut-points identifying survivors' cardiovascular fitness health-risk zones. We recruited 262 childhood cancer survivors (8-18 years old, ≥1-year posttreatment). Participants completed gold-standard cardiorespiratory fitness assessment (Cardiopulmonary Exercise Test [CPET; VO2max ]) and 6-minute walk test (6MWT). Associations with VO2max were included in a linear regression algorithm to predict VO2max , which was then cross-validated. We used Bland-Altman's limits of agreement and Receiver Operating Characteristic curves using FITNESSGRAM's "Healthy Fitness Zones" to identify cut-points for adequate cardiorespiratory fitness. A total of 199 participants (aged 13.7 ± 2.7 years, 8.5 ± 3.5 years posttreatment) were included. We found a strong positive correlation between VO2max and 6MWT distance (r = 0.61, r2 = 0.37, p 

译文

儿童癌症幸存者患心血管疾病的可能性是兄弟姐妹的 10 倍。低心肺适应性是心血管疾病的一个可变风险因素。然而，心肺适应性没有在儿科肿瘤学中常规筛查，健康的最大摄氧量切点也不可用。我们的目的是通过开发一个简单的算法来预测心肺适应性，并建立识别幸存者心血管适应性健康危险区域的切割点。我们招募了 262 名儿童癌症幸存者 (8-18 岁，治疗后 ≥ 1 年)。参与者完成了黄金标准心肺健康评估 (心肺运动测试 [CPET; VO2max]) 和 6 分钟步行测试 (6MWT)。与 VO2max 的关联包含在预测 VO2max 的线性回归算法中，然后交叉验证。我们使用 Bland-Altman 的一致性极限和使用 FITNESSGRAM 的 “健康健身区” 的受试者操作特征曲线来确定适当心肺健身的切割点。共纳入 199 名参与者 (年龄 13.7 ± 8.5 岁，治疗后 ± 岁)。我们发现最大摄氧量和 6MWT 距离之间有很强的正相关 (r = 0.61，r2 = 0.37，p