Use of Cardiopulmonary Stress Testing for Patients With Unexplained Dyspnea Post-Coronavirus Disease.
Use of Cardiopulmonary Stress Testing for Patients With Unexplained Dyspnea Post-Coronavirus Disease.
复制标题
DOI：
10.1016/j.jchf.2021.10.002
复制
发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Natelson BH
中科院分区：
文献类型：
--
作者：
Mancini DM;Brunjes DL;Lala A;Trivieri MG;Contreras JP;Natelson BH
作者使用心肺运动试验(CPET)来确定严重急性呼吸综合征-冠状病毒-2(SARS-CoV-2)感染(PASC)的急性后遗症患者的原因不明的呼吸困难。我们评估了参与者诊断肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)的标准。从冠状病毒病(COVID)中康复的患者中，约有20%仍有症状。这种综合征被称为PASC。其病因尚不清楚。呼吸困难是一种常见的症状。作者对41例COVID后8·9±3·3个月的PASC患者进行了CPET和ME/CFS症状评定。所有患者都有正常的肺功能测试、胸部X光和胸部计算机断层扫描。测定最大氧耗量(峰值VO2)、每分钟通气量与二氧化碳产生量的斜率(VE/VCO2斜率)和二氧化碳呼气末压力(PetCO2)。对呼吸模式进行回顾，呼吸功能障碍定义为快速不稳定的呼吸。男18例，女23例，平均年龄(45±13)岁。左心室射血分数为59%±239%。峰值VO2平均20.3±7 mg/kg/min(77%±21%预测VO2)。VE/VCO2斜率为30±7，静息时PETCO2为33.5±4.5 mm/Hg。24名患者(58.5%)有80%的人预测到VO2峰值。所有VO2峰值大于或等于80%的患者对运动都有循环限制。17例VO2峰值正常的患者中有15例出现呼吸机能异常，包括峰值呼吸频率55例(n=3)或呼吸功能障碍(n=12)。在整个队列中，88%的患者(n=36)有呼吸异常伴呼吸功能障碍(n=2.26)，VE/VCO2增加(n=0.17)，和/或低碳酸血症PetCO2；35(n=2.25)。19名患者(46%)符合ME/CFS标准。循环障碍、呼吸模式异常和ME/CFS在PASC患者中很常见。呼吸功能障碍、静息性低碳酸血症和ME/CFS可能与症状有关。CPET是评估这些患者的一个有价值的工具。
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). 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. 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 (PetCO2) were measured. Ventilatory patterns were reviewed with dysfunctional breathing defined as rapid erratic breathing. 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. PetCO2 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 PetCO2 <35 (n = 25). Nineteen patients (46%) met criteria for ME/CFS. 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.
登录
查看更多内容
影响因子：
2.6
作者：
Moldofsky H;Patcai J
通讯作者：
Patcai J
影响因子：
3.3
作者：
Bokov, Plamen;Fiamma, Marie-Noelle;Delclaux, Christophe
通讯作者：
Delclaux, Christophe
影响因子：
15.1
作者：
Zhao, Yu-miao;Shang, Yao-min;Xu, Ai-guo
通讯作者：
Xu, Ai-guo
影响因子：
2.7
作者：
Lavietes, MH;Natelson, BH;Tapp, WN
通讯作者：
Tapp, WN
影响因子：
37.8
作者：
SULLIVAN, MJ;HIGGINBOTHAM, MB;COBB, FR
通讯作者：
COBB, FR