{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:00:14Z","timestamp":1790398814656,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,7]],"date-time":"2019-03-07T00:00:00Z","timestamp":1551916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"NIH-NHLBI Excellence in Hemoglobinopathy Research Award program","award":["U01HL117709"],"award-info":[{"award-number":["U01HL117709"]}]},{"name":"NIH-NHLBI Excellence in Hemoglobinopathy Research Award program","award":["U01HL117709"],"award-info":[{"award-number":["U01HL117709"]}]},{"name":"Translational Research Scholar Award"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Sickle cell anemia (SCA) patients frequently have many comorbidities, including diastolic dysfunction (DD) and exercise intolerance. SCA patients often cannot reach maximal effort on exercise testing; little is known regarding whether submaximal exercise parameters can predict abnormal maximal exercise results in SCA patients and if there are any possible associations with DD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective longitudinal study was performed in SCA patients. All patients had a resting cardiac MRI (CMR), cardiopulmonary exercise test (CPET) with cycle ergometry using a ramp protocol, and an echocardiogram. Exercise data were compared with age\u2010, gender\u2010, and size\u2010matched normal controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with normal controls, the SCA group (<jats:italic>n<\/jats:italic>\u00a0=\u00a019) had lower mean max oxygen consumption (VO<jats:sub>2<\/jats:sub>; 1378 \u00b1 412\u00a0mL\/min vs 2237 \u00b1 580, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01) and workload (117 \u00b1 37.6 watts vs 175 \u00b1 50.5 watts, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0003). When evaluating the submaximal exercise parameters, there was lower VO<jats:sub>2<\/jats:sub> at the anaerobic threshold (AT; 950 \u00b1 311.7\u00a0vs 1460 \u00b1 409.9, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01) and oxygen uptake efficiency slope (OUES) at AT (1512 \u00b1 426.2\u00a0vs 2080 \u00b1 339, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). The max VO<jats:sub>2<\/jats:sub> strongly correlated with VO<jats:sub>2<\/jats:sub> at AT (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.9, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01) and OUES (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.83, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01) at AT. The VO<jats:sub>2<\/jats:sub> at AT correlated with hematocrit (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.77, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). The OUES correlated with left ventricular ejection fraction by CMR (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.55, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01), hematocrit (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.52, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02), and lateral E\/e\u2019 (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.54, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SCA patients have abnormal submaximal exercise measures compared with controls, which is strongly associated with abnormal maximal exercise results. The degree of submaximal abnormality correlates with DD abnormalities by echocardiography. These data expand the scope of functional cardiovascular abnormalities in SCA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.27703","type":"journal-article","created":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T04:09:26Z","timestamp":1552018166000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Abnormal submaximal cardiopulmonary exercise parameters predict impaired peak exercise performance in sickle cell anemia patients"],"prefix":"10.1002","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5537-032X","authenticated-orcid":false,"given":"Adam W.","family":"Powell","sequence":"first","affiliation":[{"name":"Division of Cardiology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati 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