{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T02:29:54Z","timestamp":1784687394533,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T00:00:00Z","timestamp":1554076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2019,5]]},"abstract":"Background<\/jats:title>The role of exercise stress echocardiography (ESE<\/jats:styled-content>) in the pediatric population is less well defined as compared to adults. We aimed to determine the utility and impact of ESE<\/jats:styled-content> on clinical decision\u2010making in pediatric patients.<\/jats:p><\/jats:sec>Methods<\/jats:title>We identified patients who underwent an ESE<\/jats:styled-content> at our center from 2011 to 2015. Test indications were categorized into symptoms with exercise; sports\/activity clearance; hypertrophic cardiomyopathy (HCM<\/jats:styled-content>) or suspected HCM<\/jats:styled-content>; coronary anomalies; or abnormal electrocardiogram (EKG<\/jats:styled-content>). Change in clinical management was assessed by comparing pre\u2010 and post\u2010test activity restrictions, which were categorized into unrestricted from exercise or activity; restricted from exercise or activity; and surgical referral.<\/jats:p><\/jats:sec>Results<\/jats:title>During the study period, 353 ESE<\/jats:styled-content>s met inclusion criteria. Of all ESE<\/jats:styled-content>s performed, 263 (75%) were normal. Clinical management changed as a result of ESE<\/jats:styled-content> in 144 (40%). Of the abnormal ESE<\/jats:styled-content>s, 44 were restricted from activity, including 25 (56.8%) restricted from competitive or varsity athletics, 14 (31.8%) restricted from recreational sports, and 5 (11.4%) restricted from all activity. Surgical referrals included valve repair\/replacement in 7 (50%), ICD<\/jats:styled-content> placement in 5 (35.8%), coronary re\u2010implantation in 1 (7.1%), and atrial septal defect repair in 1 (7.1%).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Exercise stress echocardiography provides the pediatric cardiologist with useful information that impacts management in a wide variety of cardiac disorders. Clinical management changed in nearly half the patients that were subjected to an ESE<\/jats:styled-content> at our center. This supports the value of ESE<\/jats:styled-content> for informing clinical decision\u2010making. Future studies should aim to refine patient selection and examine its impact on patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14326","type":"journal-article","created":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T19:17:21Z","timestamp":1554146241000},"page":"938-943","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Exercise stress echocardiography: Impact on clinical decision\u2010making in pediatric patients"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8746-1277","authenticated-orcid":false,"given":"Soham","family":"Dasgupta","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics, Children's Healthcare of Atlanta Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Friedman","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Allen","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Stark","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics, Children's Healthcare of Atlanta Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritu","family":"Sachdeva","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics, Children's Healthcare of Atlanta Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William L.","family":"Border","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics, Children's Healthcare of Atlanta Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1476-7120-11-26"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.12.005"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2016.10.016"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1071-3581(02)43235-7"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2008.11.014"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.001"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.008"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev159"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2011.12.014"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.13316"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1970.29.1.82"},{"issue":"5","key":"e_1_2_6_13_1","first-page":"22","article-title":"Treadmill and bicycle ergometer exercise: cardiovascular response comparison","volume":"12","author":"Kisan R","year":"2012","journal-title":"Glob J Med Res"},{"key":"e_1_2_6_14_1","first-page":"1377A","article-title":"Standards for exercise testing in the pediatric age group. American Heart Association Council on Cardiovascular Disease in the Young. Ad hoc committee on exercise testing","volume":"66","author":"James FW","year":"1982","journal-title":"Circulation"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI102207"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI102208"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12495"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.14326","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/echo.14326","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.14326","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T11:52:18Z","timestamp":1694346738000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.14326"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1111\/echo.14326"],"URL":"https:\/\/doi.org\/10.1111\/echo.14326","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]},"assertion":[{"value":"2019-01-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}