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10.1016/j.chest.2021.08.010 http://scihub22266oqcxt.onion/10.1016/j.chest.2021.08.010 34389297!8354807!34389297     free     free     free Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 261.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Chest 2022 ; 161 (1): 54-63 Nephropedia Template TP {{tp|p=34389297|t=2022. Persistent Exertional Intolerance After COVID-19: Insights From Invasive Cardiopulmonary Exercise Testing |pdf=|usr=}}{{34389297}} gab.com Text Persistent Exertional Intolerance After COVID-19: Insights From Invasive Cardiopulmonary Exercise Testing JO: Chest http://www.kidney.de/pget.php?&tw=1&pmid=34389297 #FOAvip BACKGROUND: Some patients with COVID-19 who have recovered from the acute infection after experiencing only mild symptoms continue to exhibit persistent exertional limitation that often is unexplained by conventional investigative studies. RESEARCH QUESTION: What is the pathophysiologic mechanism of exercise intolerance that underlies the post-COVID-19 long-haul syndrome in patients without cardiopulmonary disease? STUDY DESIGN AND METHODS: This study examined the systemic and pulmonary hemodynamics, ventilation, and gas exchange in 10 patients who recovered from COVID-19 and were without cardiopulmonary disease during invasive cardiopulmonary exercise testing (iCPET) and compared the results with those from 10 age- and sex-matched control participants. These data then were used to define potential reasons for exertional limitation in the cohort of patients who had recovered from COVID-19. RESULTS: The patients who had recovered from COVID-19 exhibited markedly reduced peak exercise aerobic capacity (oxygen consumption [VO(2)]) compared with control participants (70 +/- 11% predicted vs 131 +/- 45% predicted; P < .0001). This reduction in peak VO(2) was associated with impaired systemic oxygen extraction (ie, narrow arterial-mixed venous oxygen content difference to arterial oxygen content ratio) compared with control participants (0.49 +/- 0.1 vs 0.78 +/- 0.1; P < .0001), despite a preserved peak cardiac index (7.8 +/- 3.1 L/min vs 8.4+/-2.3 L/min; P > .05). Additionally, patients who had recovered from COVID-19 demonstrated greater ventilatory inefficiency (ie, abnormal ventilatory efficiency [VE/VCO(2)] slope: 35 +/- 5 vs 27 +/- 5; P = .01) compared with control participants without an increase in dead space ventilation. INTERPRETATION: Patients who have recovered from COVID-19 without cardiopulmonary disease demonstrate a marked reduction in peak VO(2) from a peripheral rather than a central cardiac limit, along with an exaggerated hyperventilatory response during exercise. Twit Text FOAVip Persistent Exertional Intolerance After COVID-19: Insights From Invasive Cardiopulmonary Exercise Testing ????Chest http://www.kidney.de/pget.php?&tw=1&pmid=34389297 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=34389297 #FOAvip English Wikipedia <ref>{{Cite pmid|34389297}}</ref> Persistent Exertional Intolerance After COVID-19: Insights From Invasive Cardiopulmonary Exercise Testing #MMPMID34389297 Singh I; Joseph P; Heerdt PM; Cullinan M; Lutchmansingh DD; Gulati M; Possick JD; Systrom DM; Waxman AB Chest 2022[Jan]; 161 (1): 54-63 PMID34389297show ga BACKGROUND: Some patients with COVID-19 who have recovered from the acute infection after experiencing only mild symptoms continue to exhibit persistent exertional limitation that often is unexplained by conventional investigative studies. RESEARCH QUESTION: What is the pathophysiologic mechanism of exercise intolerance that underlies the post-COVID-19 long-haul syndrome in patients without cardiopulmonary disease? STUDY DESIGN AND METHODS: This study examined the systemic and pulmonary hemodynamics, ventilation, and gas exchange in 10 patients who recovered from COVID-19 and were without cardiopulmonary disease during invasive cardiopulmonary exercise testing (iCPET) and compared the results with those from 10 age- and sex-matched control participants. These data then were used to define potential reasons for exertional limitation in the cohort of patients who had recovered from COVID-19. RESULTS: The patients who had recovered from COVID-19 exhibited markedly reduced peak exercise aerobic capacity (oxygen consumption [VO(2)]) compared with control participants (70 +/- 11% predicted vs 131 +/- 45% predicted; P < .0001). This reduction in peak VO(2) was associated with impaired systemic oxygen extraction (ie, narrow arterial-mixed venous oxygen content difference to arterial oxygen content ratio) compared with control participants (0.49 +/- 0.1 vs 0.78 +/- 0.1; P < .0001), despite a preserved peak cardiac index (7.8 +/- 3.1 L/min vs 8.4+/-2.3 L/min; P > .05). Additionally, patients who had recovered from COVID-19 demonstrated greater ventilatory inefficiency (ie, abnormal ventilatory efficiency [VE/VCO(2)] slope: 35 +/- 5 vs 27 +/- 5; P = .01) compared with control participants without an increase in dead space ventilation. INTERPRETATION: Patients who have recovered from COVID-19 without cardiopulmonary disease demonstrate a marked reduction in peak VO(2) from a peripheral rather than a central cardiac limit, along with an exaggerated hyperventilatory response during exercise. |*Exercise Tolerance[MESH] |COVID-19/*complications/physiopathology[MESH] |Connecticut[MESH] |Exercise Test/*methods[MESH] |Female[MESH] |Hemodynamics/physiology[MESH] |Humans[MESH] |Male[MESH] |Massachusetts[MESH] |Middle Aged[MESH] |Oxygen Consumption/physiology[MESH] |Post-Acute COVID-19 Syndrome[MESH] |Respiratory Function Tests[MESH] |SARS-CoV-2[MESH]Persistent Exertional Intolerance After COVID-19: Insights From Invasi(epmc).pdf DeepDyve Pubget Overpricing