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
School of Medicine in Sports and Exercise, University of Verona, 37134 Verona, Italy.
Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy.
Diagnostics (Basel). 2021 Mar 12;11(3):507. doi: 10.3390/diagnostics11030507.
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.
心肺运动试验（CPET）可对通气受限进行客观评估，该评估与运动分钟通气量（V）与二氧化碳排出量（V）的比值（V/V）相关；V/V值高表明运动通气效率低下（EV）。在从COVID-19住院中康复的受试者中，我们探索了CPET的方法，以评估心肺改变的存在情况。我们开展了一项前瞻性研究（RESPICOVID），以评估COVID后受试者肺部损伤的临床影响。在一个没有基线混杂因素的受试者亚组（RESPICOVID2）中，我们进行了CPET。根据V/V，将受试者分为存在运动通气效率低下（EV）和运动通气效率正常（EV）两组。还收集了有关一般变量、住院情况、肺功能和气体分析的数据。RESPICOVID2纳入了28名受试者，其中8名（29%）存在运动通气效率低下（EV）。与运动通气效率正常（EV）的受试者相比，运动通气效率低下（EV）的受试者心率（HR）恢复情况较差。V/V与HR恢复呈负相关；在老年、不吸烟男性受试者亚组中，无论是否存在动脉高血压，这种相关性均得到证实。超过四分之一从COVID-19住院中康复的受试者存在运动通气效率低下（EV）。运动通气效率低下（EV）与HR恢复之间的关系可能代表了COVID后心肺改变的一个新特征。
