Use of Cardiopulmonary Stress Testing for Patients With Unexplained Dyspnea Post-Coronavirus Disease
被引:133
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作者:
Mancini, Donna M.
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机构:
Icahn Sch Med Mt Sinai, Dept Cardiol, 1 Gustave L Levy Pl,POB 1077, New York, NY 10029 USA
Icahn Sch Med Mt Sinai, Dept Populat Hlth Sci & Policy, New York, NY 10029 USAIcahn Sch Med Mt Sinai, Dept Cardiol, 1 Gustave L Levy Pl,POB 1077, New York, NY 10029 USA
Mancini, Donna M.
[1
,2
]
Brunjes, Danielle L.
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机构:
Icahn Sch Med Mt Sinai, Dept Cardiol, 1 Gustave L Levy Pl,POB 1077, New York, NY 10029 USAIcahn Sch Med Mt Sinai, Dept Cardiol, 1 Gustave L Levy Pl,POB 1077, New York, NY 10029 USA
Brunjes, Danielle L.
[1
]
Lala, Anuradha
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机构:
Icahn Sch Med Mt Sinai, Dept Cardiol, 1 Gustave L Levy Pl,POB 1077, New York, NY 10029 USA
Icahn Sch Med Mt Sinai, Dept Populat Hlth Sci & Policy, New York, NY 10029 USAIcahn Sch Med Mt Sinai, Dept Cardiol, 1 Gustave L Levy Pl,POB 1077, New York, NY 10029 USA
Lala, Anuradha
[1
,2
]
Trivieri, Maria Giovanna
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机构:
Icahn Sch Med Mt Sinai, Dept Cardiol, 1 Gustave L Levy Pl,POB 1077, New York, NY 10029 USAIcahn Sch Med Mt Sinai, Dept Cardiol, 1 Gustave L Levy Pl,POB 1077, New York, NY 10029 USA
Trivieri, Maria Giovanna
[1
]
Contreras, Johanna P.
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机构:
Icahn Sch Med Mt Sinai, Dept Cardiol, 1 Gustave L Levy Pl,POB 1077, New York, NY 10029 USAIcahn Sch Med Mt Sinai, Dept Cardiol, 1 Gustave L Levy Pl,POB 1077, New York, NY 10029 USA
Contreras, Johanna P.
[1
]
Natelson, Benjamin H.
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机构:
Icahn Sch Med Mt Sinai, Dept Neurol, New York, NY 10029 USAIcahn Sch Med Mt Sinai, Dept Cardiol, 1 Gustave L Levy Pl,POB 1077, New York, NY 10029 USA
Natelson, Benjamin H.
[3
]
机构:
[1] Icahn Sch Med Mt Sinai, Dept Cardiol, 1 Gustave L Levy Pl,POB 1077, New York, NY 10029 USA
[2] Icahn Sch Med Mt Sinai, Dept Populat Hlth Sci & Policy, New York, NY 10029 USA
[3] Icahn Sch Med Mt Sinai, Dept Neurol, New York, NY 10029 USA
cardiopulmonary exercise testing;
dyspnea;
post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection;
CHRONIC-FATIGUE-SYNDROME;
EXERCISE;
VENTILATION;
D O I:
10.1016/j.jchf.2021.10.002
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
OBJECTIVES The authors used cardiopulmonary exercise testing (CPET) to define unexplained dyspnea in patients with post-acute sequelae of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection (PASC). We assessed participants for criteria to diagnose myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). BACKGROUND Approximately 20% of patients who recover from coronavirus disease (COVID) remain symptomatic. This syndrome is named PASC. Its etiology is unclear. Dyspnea is a frequent symptom. METHODS The authors performed CPET and symptom assessment for ME/CFS in 41 patients with PASC 8.9 +/- 3.3 months after COVID. All patients had normal pulmonary function tests, chest X-ray, and chest computed tomography scans. Peak oxygen consumption (peak VO2), slope of minute ventilation to CO2 production (VE/VCO2 slope), and end tidal pressure of CO2 (PetCO(2)) were measured. Ventilatory patterns were reviewed with dysfunctional breathing defined as rapid erratic breathing. RESULTS Eighteen men and 23 women (average age: 45 +/- 13 years) were studied. Left ventricular ejection fraction was 59% +/- 9%. Peak VO2 averaged 20.3 +/- 7 mL/kg/min (77% +/- 21% predicted VO2). VE/VCO2 slope was 30 +/- 7. PetCO(2) at rest was 33.5 +/- 4.5 mm Hg. Twenty-four patients (58.5%) had a peak VO2 <80% predicted. All patients with peak VO2 <80% had a circulatory limitation to exercise. Fifteen of 17 patients with normal peak VO2 had ventilatory abnormalities including peak respiratory rate >55 (n = 3) or dysfunctional breathing (n = 12). For the whole cohort, 88% of patients (n = 36) had ventilatory abnormalities with dysfunctional breathing (n = 26), increased VE/VCO2 (n = 17), and/or hypocapnia PetCO(2) <35 (n = 25). Nineteen patients (46%) met criteria for ME/CFS. CONCLUSIONS Circulatory impairment, abnormal ventilatory pattern, and ME/CFS are common in patients with PASC. The dysfunctional breathing, resting hypocapnia, and ME/CFS may contribute to symptoms. CPET is a valuable tool to assess these patients. (C) 2021 by the American College of Cardiology Foundation.
机构:
NDMC Med Coll, Dept Resp Med, New Delhi, India
PGIMS, Pt BD Sharma, Room 304, Rohtak 124001, Haryana, IndiaNDMC Med Coll, Dept Resp Med, New Delhi, India
Nain, Sandeep
Gupta, Rajesh
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机构:
NDMC Med Coll, Dept Resp Med, New Delhi, IndiaNDMC Med Coll, Dept Resp Med, New Delhi, India
Gupta, Rajesh
Gupta, Anupama
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机构:
NDMC Med Coll, Dept Physiol, New Delhi, IndiaNDMC Med Coll, Dept Resp Med, New Delhi, India
Gupta, Anupama
Verma, Sheetal
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机构:
NDMC Med Coll, Dept Resp Med, New Delhi, IndiaNDMC Med Coll, Dept Resp Med, New Delhi, India
Verma, Sheetal
Gupta, Raghav
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机构:
NDMC Med Coll, New Delhi, IndiaNDMC Med Coll, Dept Resp Med, New Delhi, India
Gupta, Raghav
Parmar, Aparna
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机构:
PGIMS, Microbiol, Pt BD Sharma, Rohtak, Haryana, IndiaNDMC Med Coll, Dept Resp Med, New Delhi, India
Parmar, Aparna
EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS,
2023,
72
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: 534
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