Importance of Cardiopulmonary Exercise Testing amongst Subjects Recovering from COVID-19

The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (VE) coupled to carbon dioxide output (VCO2) (VE/VCO2); high values of VE/VCO2 slope define an exercise ventilatory inefficiency (EVin). In subjects recover...

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Veröffentlicht in:Diagnostics (Basel) Jg. 11; H. 3; S. 507
Hauptverfasser: Dorelli, Gianluigi, Braggio, Michele, Gabbiani, Daniele, Busti, Fabiana, Caminati, Marco, Senna, Gianenrico, Girelli, Domenico, Laveneziana, Pierantonio, Ferrari, Marcello, Sartori, Giulia, Dalle Carbonare, Luca, Crisafulli, Ernesto
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Veröffentlicht: Switzerland MDPI 12.03.2021
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Abstract The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (VE) coupled to carbon dioxide output (VCO2) (VE/VCO2); high values of VE/VCO2 slope define an exercise ventilatory inefficiency (EVin). In subjects recovered from hospitalised COVID-19, we explored the methodology of CPET in order to evaluate the presence of cardiopulmonary alterations. Our prospective study (RESPICOVID) has been proposed to evaluate pulmonary damage’s clinical impact in post-COVID subjects. In a subgroup of subjects (RESPICOVID2) without baseline confounders, we performed the CPET. According to the VE/VCO2 slope, subjects were divided into having EVin and exercise ventilatory efficiency (EVef). Data concerning general variables, hospitalisation, lung function, and gas-analysis were also collected. The RESPICOVID2 enrolled 28 subjects, of whom 8 (29%) had EVin. As compared to subjects with EVef, subjects with EVin showed a reduction in heart rate (HR) recovery. VE/VCO2 slope was inversely correlated with HR recovery; this correlation was confirmed in a subgroup of older, non-smoking male subjects, regardless of the presence of arterial hypertension. More than one-fourth of subjects recovered from hospitalised COVID-19 have EVin. The relationship between EVin and HR recovery may represent a novel hallmark of post-COVID cardiopulmonary alterations.
AbstractList The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (VE) coupled to carbon dioxide output (VCO2) (VE/VCO2); high values of VE/VCO2 slope define an exercise ventilatory inefficiency (EVin). In subjects recovered from hospitalised COVID-19, we explored the methodology of CPET in order to evaluate the presence of cardiopulmonary alterations. Our prospective study (RESPICOVID) has been proposed to evaluate pulmonary damage's clinical impact in post-COVID subjects. In a subgroup of subjects (RESPICOVID2) without baseline confounders, we performed the CPET. According to the VE/VCO2 slope, subjects were divided into having EVin and exercise ventilatory efficiency (EVef). Data concerning general variables, hospitalisation, lung function, and gas-analysis were also collected. The RESPICOVID2 enrolled 28 subjects, of whom 8 (29%) had EVin. As compared to subjects with EVef, subjects with EVin showed a reduction in heart rate (HR) recovery. VE/VCO2 slope was inversely correlated with HR recovery; this correlation was confirmed in a subgroup of older, non-smoking male subjects, regardless of the presence of arterial hypertension. More than one-fourth of subjects recovered from hospitalised COVID-19 have EVin. The relationship between EVin and HR recovery may represent a novel hallmark of post-COVID cardiopulmonary alterations.The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (VE) coupled to carbon dioxide output (VCO2) (VE/VCO2); high values of VE/VCO2 slope define an exercise ventilatory inefficiency (EVin). In subjects recovered from hospitalised COVID-19, we explored the methodology of CPET in order to evaluate the presence of cardiopulmonary alterations. Our prospective study (RESPICOVID) has been proposed to evaluate pulmonary damage's clinical impact in post-COVID subjects. In a subgroup of subjects (RESPICOVID2) without baseline confounders, we performed the CPET. According to the VE/VCO2 slope, subjects were divided into having EVin and exercise ventilatory efficiency (EVef). Data concerning general variables, hospitalisation, lung function, and gas-analysis were also collected. The RESPICOVID2 enrolled 28 subjects, of whom 8 (29%) had EVin. As compared to subjects with EVef, subjects with EVin showed a reduction in heart rate (HR) recovery. VE/VCO2 slope was inversely correlated with HR recovery; this correlation was confirmed in a subgroup of older, non-smoking male subjects, regardless of the presence of arterial hypertension. More than one-fourth of subjects recovered from hospitalised COVID-19 have EVin. The relationship between EVin and HR recovery may represent a novel hallmark of post-COVID cardiopulmonary alterations.
The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (VE) coupled to carbon dioxide output (VCO2) (VE/VCO2); high values of VE/VCO2 slope define an exercise ventilatory inefficiency (EVin). In subjects recovered from hospitalised COVID-19, we explored the methodology of CPET in order to evaluate the presence of cardiopulmonary alterations. Our prospective study (RESPICOVID) has been proposed to evaluate pulmonary damage’s clinical impact in post-COVID subjects. In a subgroup of subjects (RESPICOVID2) without baseline confounders, we performed the CPET. According to the VE/VCO2 slope, subjects were divided into having EVin and exercise ventilatory efficiency (EVef). Data concerning general variables, hospitalisation, lung function, and gas-analysis were also collected. The RESPICOVID2 enrolled 28 subjects, of whom 8 (29%) had EVin. As compared to subjects with EVef, subjects with EVin showed a reduction in heart rate (HR) recovery. VE/VCO2 slope was inversely correlated with HR recovery; this correlation was confirmed in a subgroup of older, non-smoking male subjects, regardless of the presence of arterial hypertension. More than one-fourth of subjects recovered from hospitalised COVID-19 have EVin. The relationship between EVin and HR recovery may represent a novel hallmark of post-COVID cardiopulmonary alterations.
The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (V ) coupled to carbon dioxide output (V ) (V /V ); high values of V /V define an exercise ventilatory inefficiency (EV ). In subjects recovered from hospitalised COVID-19, we explored the methodology of CPET in order to evaluate the presence of cardiopulmonary alterations. Our prospective study (RESPICOVID) has been proposed to evaluate pulmonary damage's clinical impact in post-COVID subjects. In a subgroup of subjects (RESPICOVID2) without baseline confounders, we performed the CPET. According to the V /V , subjects were divided into having EV and exercise ventilatory efficiency (EV ). Data concerning general variables, hospitalisation, lung function, and gas-analysis were also collected. The RESPICOVID2 enrolled 28 subjects, of whom 8 (29%) had EV . As compared to subjects with EV , subjects with EV showed a reduction in heart rate (HR) recovery. V /V was inversely correlated with HR recovery; this correlation was confirmed in a subgroup of older, non-smoking male subjects, regardless of the presence of arterial hypertension. More than one-fourth of subjects recovered from hospitalised COVID-19 have EV . The relationship between EV and HR recovery may represent a novel hallmark of post-COVID cardiopulmonary alterations.
Author Laveneziana, Pierantonio
Girelli, Domenico
Dalle Carbonare, Luca
Dorelli, Gianluigi
Senna, Gianenrico
Ferrari, Marcello
Crisafulli, Ernesto
Braggio, Michele
Gabbiani, Daniele
Sartori, Giulia
Busti, Fabiana
Caminati, Marco
AuthorAffiliation 2 Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; daniele.gabbiani@yahoo.com (D.G.); fabiana.busti@univr.it (F.B.); domenico.girelli@univr.it (D.G.); giulia.sartori.verona@gmail.com (G.S.)
3 Department of Medicine, Allergy and Clinical Immunology Section, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; marco.caminati@univr.it (M.C.); gianenrico.senna@univr.it (G.S.)
4 INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, AP-HP, Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Explorations Fonctionnelles de la Respiration, de l’Exercice et de la Dyspnée du Département Médico-Universitaire «APPROCHES», 75013 Paris, France; pierantonio.laveneziana@aphp.fr
5 Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Ital
AuthorAffiliation_xml – name: 1 School of Medicine in Sports and Exercise, University of Verona, 37134 Verona, Italy; gianluigi.dorelli@gmail.com (G.D.); michele.braggio@gmail.com (M.B.); marcello.ferrari@univr.it (M.F.); luca.dallecarbonare@univr.it (L.D.C.)
– name: 4 INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, AP-HP, Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Explorations Fonctionnelles de la Respiration, de l’Exercice et de la Dyspnée du Département Médico-Universitaire «APPROCHES», 75013 Paris, France; pierantonio.laveneziana@aphp.fr
– name: 3 Department of Medicine, Allergy and Clinical Immunology Section, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; marco.caminati@univr.it (M.C.); gianenrico.senna@univr.it (G.S.)
– name: 5 Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy
– name: 2 Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; daniele.gabbiani@yahoo.com (D.G.); fabiana.busti@univr.it (F.B.); domenico.girelli@univr.it (D.G.); giulia.sartori.verona@gmail.com (G.S.)
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Issue 3
Keywords COVID-19
cardiopulmonary exercise test
cardiovascular alterations
exercise ventilatory inefficiency
heart rate recovery
Language English
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Membership of the RESPICOVID study investigators is provided in Acknowledgments.
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Snippet The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (VE) coupled to...
The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (V ) coupled to...
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SubjectTerms Brief Report
cardiopulmonary exercise test
cardiovascular alterations
COVID-19
exercise ventilatory inefficiency
heart rate recovery
Life Sciences
Title Importance of Cardiopulmonary Exercise Testing amongst Subjects Recovering from COVID-19
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