(1) Background: To assess the impact of excessive body fat on cardiorespiratory fitness (CRF) and coronary artery health in children and adolescents following acute Kawasaki disease (KD-CA). (2) Methods: A retrospective study of KD-CA patients (ages 8–16) who completed cardiopulmonary exercise testing (CPET) in the last five years. Participants were classified based on body mass index (BMI) and fat mass index (FMI) into normal and excessive adiposity groups. Coronary artery (CA) Z-scores were calculated using the Lambda-Mu-Sigma method, with peak VO2 Z-scores (peak VO2 Z-score) derived from a database of Hong Kong Chinese children and adolescents. Primary outcomes included peak VO2 Z-score, Max-Z (maximum CA Z-score), anaerobic threshold metabolic equivalent (AT MET), peak MET, and pulse oxygen. Statistical analyses were conducted to evaluate differences across groups. (3) Results: A total of 112 KD-CA patients were included (mean age: 11.71 ± 2.54 years). The mean peak VO2 Z-score was −0.63 ± 0.98. Participants with normal BMI and FMI had significantly higher pulse oxygen levels compared to those with excessive BMI and FMI (both p < 0.001). Additionally, those with normal FMI showed higher AT MET, peak MET, peak VO2 Z-score (p = 0.049), and lower Max-Z (p = 0.026) than excessive FMI participants. Boys, especially those with normal adiposity, had superior AT MET, peak MET, pulse oxygen, and Max-Z compared to girls. (4) Conclusions: Excessive adiposity in KD-CA patients is associated with reduced CRF and elevated Max CA Z-score. These findings highlight the need to monitor body composition to optimize cardiovascular health in this population.

(1) Background: Heart failure (HF) leads to functional disability and major cardiovascular events (MACEs). Cardiopulmonary exercise testing (CPET) is the gold standard for assessing aerobic capacity and prognostic stratification. This study aimed to evaluate the predischarge CPET variables in patients with acute decompensated HF and identify the submaximal CPET variables with prognostic value. (2) Methods: A retrospective cohort study was conducted at a tertiary center in Taiwan. Patients surviving their first episode of decompensated HF and undergoing predischarge CPET (February 2017 to January 2023) were analyzed. Follow-up was conducted until a MACE or administrative censoring (up to 5 years). Cox regression identified the significant predictors of MACE. (3) Results: The study included 553, 485, and 267 patients at the 3-month, 1-year, and 5-year follow-ups, respectively. MACE rates were 15.0%, 34.2%, and 50.9%. The VE/VCO2 slope was a significant predictor of MACE at all intervals. A VE/VCO2 slope >38.95 increased the risk of MACE by 2.49-fold at 3 months and 1.81-fold at 1 year (both p < 0.001). A slope > 37.35 increased the 5-year MACE risk by 1.75-fold (p = 0.002). (4) Conclusions: The VE/VCO2 slope is a significant submaximal CPET predictor of MACE in patients post-acute decompensated HF for both short- and long-term outcomes.

This study investigated the cardiopulmonary function of prepubertal patients with Kawasaki Disease (KD) and compared it with that of healthy controls. Retrospective cohort study METHODS: Data were collected from two medical centers in Taiwan from January 2014 to December 2023. Patients aged 8 to 12 years with a KD history were recruited. All patients and controls (age-, sex-, and body mass index -matched) underwent Cardiopulmonary Exercise Test (CPET) and pulmonary function test. A total of 117 KD patients (mean age 9.64 ± 1.66 years; 68 males (58.1 %); (Body Mass Index [BMI] 19.21 ± 4.20 kg/m²) and 121 controls (mean age 9.72 ± 1.66 years; 71 males (58.7 %); BMI 18.47 ± 3.30 kg/m²) were analyzed. The average time from illness onset to enrollment was 7.94 ± 2.84 years. No significant differences in demographic characteristics or pulmonary function were observed. However, the KD group exhibited lower aerobic capacity (24.32 ± 5.02 vs. 26.08 ± 4.89 mL/min/kg, p < 0.001) and peak exercise tolerance (35.43 ± 7.31 vs. 38.48 ± 6.24 mL/min/kg, p < 0.001) compared to controls. Furthermore, the KD group had lower cardiopulmonary function than the control group among males, whereas the difference in females did not reach statistical significance. Prepubertal individuals with a KD history demonstrated lower aerobic capacity and peak exercise tolerance than healthy peers, particularly among males. Despite this, they can safely engage in moderate-to-vigorous physical activities, which are essential for maintaining cardiopulmonary health in later life. Encouraging regular exercise among these patients is crucial.