It is known that children and adolescents with Kawasaki disease (KD) can maintain normal cardiopulmonary fitness (CPF) after the disease’s acute stage has subsided. This study aimed to investigate whether gender differences affect CPF in children and adolescents with KD. We retrospectively reviewed a cohort of 204 participants (120 boys and 84 girls) with KD. All participants were instructed to complete a symptom-limited cardiopulmonary exercise test (CPET) adapted to assess their CPF. Based on body mass index (BMI), boys and girls were categorized into groups of underweight (19 boys and 12 girls), normal (62 boys and 59 girls), and overweight (39 boys and 13 girls). Although a similarity in body composition was found among both genders for KD subjects and normal Taiwanese peers, the percentage of overweight subjects was higher in KD boys than the normal Taiwanese boys. When comparing CPF for different BMI groups, the whole KD group showed no discrepancy, but a significantly lower peak VO2 for the overweight KD boys group was observed, representing poorer CPF. In conclusion, girls with KD had better CPF than boys, and gender stereotypes affect sports participation as well as self-efficacy, and may be contributing to poorer CPF in KD boys.

(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.

Sarcopenia is highly prevalent among stroke patients and is associated with poor functional outcomes; however, differences across stroke stages and age groups remain unclear. This cross-sectional study enrolled 80 stroke patients from a regional teaching hospital in Taiwan, categorized into chronic (n = 40) and post-acute care (PAC) groups (n = 40), and further stratified into younger (40–64 years, n = 44) and older (≥65 years, n = 36) groups. Assessments included body composition, muscle strength, ultrasound-measured muscle thickness, gait speed, calf circumference, sarcopenia screening (SARC-F), nutritional status, and health-related quality of life. No significant differences were observed in muscle mass, muscle strength, or ultrasound-derived muscle thickness between the chronic and PAC groups. However, the PAC group demonstrated poorer functional outcomes and health-related quality of life, including lower gait speed (p = 0.018), and lower EQ-5D index and visual analogue scale scores (p = 0.006 and p = 0.002, respectively). In contrast, the chronic group showed a higher prevalence of sarcopenia (p < 0.001), a higher mean SARC-F scores (p = 0.004), a greater proportion of low appendicular skeletal muscle mass index (ASMMI, p = 0.025), and reduced calf circumference (p < 0.001). Age-stratified analysis revealed that older patients had lower muscle mass and structural parameters, including ASMMI (p < 0.001), fat-free mass (p < 0.001), quadriceps thickness (p < 0.001), and calf circumference (p = 0.002), along with a higher prevalence of sarcopenia (p < 0.001). These findings indicate that stroke stage is more closely associated with functional impairment, whereas aging predominantly affects muscle mass and sarcopenia severity.

Heart failure (HF) is a complex clinical syndrome characterized by impaired exercise capacity and reduced quality of life. While musculoskeletal conditions such as degenerative lumbar spine disease (DLSD) are common in older adults, their contribution to exercise intolerance in HF patients remains under-investigated. This retrospective cohort study evaluated the relationship between DLSD and functional capacity in HF patients using cardiopulmonary exercise testing (CPET) and the six-minute walk test (6MWT). We included 286 HF patients who underwent CPET following hospitalization for acute decompensated HF. Based on imaging findings, patients were divided into DLSD (n = 143) and non-DLSD (n = 143) groups after propensity score matching for age, sex, and BMI. The DLSD group exhibited significantly poorer exercise tolerance, with lower oxygen uptake efficiency slope (OUES) (1.05 ± 0.44 vs. 1.17 ± 0.45; p = 0.017) and shorter 6MWT distances (244.9 ± 130.36 vs. 283.36 ± 132.22 m; p = 0.014). Multivariate logistic regression adjusting for age, sex, BMI, and comorbidities revealed that higher OUES and longer 6MWT distances were independently associated with reduced odds of DLSD (OUES: OR = 0.477; 95% CI: 0.259-0.879; p = 0.018; 6MWT: OR = 0.997; 95% CI: 0.995-0.999; p = 0.01). These findings suggest that DLSD may exacerbate exercise intolerance in HF and highlight the value of CPET and 6MWT in identifying high-risk subgroups. Early recognition of DLSD may facilitate tailored rehabilitation strategies to improve clinical outcomes in patients with HF.