This study aims to more accurately assess cardiac function, ventilation and exercise capacity in a non-invasive fashion, and to better characterize exercise intolerance in the setting of three populations of individuals with chronic diseases of childhood (acute lymphoblastic leukemia (ALL), chronic lung disease (CLD) of prematurity, and post-heart transplant (HT))
Acute lymphoblastic leukemia survivor, OR living with chronic lung disease of prematurity, OR living with heart transplant
8-25 years old
Height: ≥ 48 inches
Ambulatory without assistance
ALL specific: received cranial radiation, bone marrow transplant recipients
Investigator or patient's primary physician deems the patient unsuitable for the study
History of malignancy, CLD or HT or any other diagnosis which may reduce cardiorespiratory function
Investigator deems the patient unsuitable for the study
The case participants are the ALL survivors, CLD due to prematurity patients, and post-HT recipients. The control participants can be medical students, UMN staff's children, UMN/Fairview staff, medical residents and undergraduate or graduate students. The remaining controls will be from other UMMCH clinics with conditions unlikely to impact exercise capacity such as dermatology, orthopedics or sports medicine and the University Children's Clinic. Approval will be granted from the treating physician before approaching the control participants
Case-control
Prospective
Physical activity
Other interventionParticipant Reported Physical Activity and Outcomes (completed via REDCap or on paper)
Measure of Peak O2 intake during test exercise
Maximal cardiopulmonary exercise testing (CPX) will be completed on cycle ergometer to determine peak oxygen uptake, a measure of cardiorespiratory fitness
Measure of Cardiac output during test exercise
Cardiac output is measured using C2H2 open-circuit breathing technique: a mass spectrometer medical gas analyzer will measure gas concentration continuously, yielding serial Stroke Volume measurements during incremental exercise. Cardiac output is the product of heart rate and stroke volume
The proportion of expiratory flow limitation (EFL)
The proportion of expiratory flow limitation (EFL) during exercise while tracking dyspnea and perceived exertion
Association between cardiac function and patient reported outcomes of perceived fitness
Logistic regression will be used to understand associations between cardiac function and patient reported outcomes of perceived fitness
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