{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:14:41Z","timestamp":1760145281620,"version":"build-2065373602"},"reference-count":46,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Cardiorespiratory complications are commonly reported among patients with long COVID-19 syndrome. However, their effects on exercise capacity remain inconclusive. We investigated the impact of long COVID-19 on exercise tolerance combining cardiopulmonary exercise testing (CPET) with resting echocardiographic data. Methods: Forty-two patients (55 \u00b1 13 years), 149 \u00b1 92 days post-hospital discharge, and ten healthy age-matched participants underwent resting echocardiography and an incremental CPET to the limit of tolerance. Left ventricular global longitudinal strain (LV-GLS) and the left ventricular ejection fraction (LVEF) were calculated to assess left ventricular systolic function. The E\/e\u2019 ratio was estimated as a surrogate of left ventricular end-diastolic filling pressures. Tricuspid annular systolic velocity (SRV) was used to assess right ventricular systolic performance. Through tricuspid regurgitation velocity and inferior vena cava diameter, end-respiratory variations in systolic pulmonary artery pressure (PASP) were estimated. Peak work rate (WRpeak) and peak oxygen uptake (VO2peak) were measured via a ramp incremental symptom-limited CPET. Results: Compared to healthy participants, patients had a significantly (p &lt; 0.05) lower LVEF (59 \u00b1 4% versus 49 \u00b1 5%) and greater left ventricular end-diastolic diameter (48 \u00b1 2 versus 54 \u00b1 5 cm). In patients, there was a significant association of E\/e\u2019 with WRpeak (r = \u22120.325) and VO2peak (r = \u22120.341). SRV was significantly associated with WRpeak (r = 0.432) and VO2peak (r = 0.556). LV-GLS and PASP were significantly correlated with VO2peak (r = \u22120.358 and r = \u22120.345, respectively). Conclusions: In patients with long COVID-19 syndrome, exercise intolerance is associated with left ventricular diastolic performance, left ventricular end-diastolic pressure, PASP and SRV. These findings highlight the interrelationship of exercise intolerance with left and right ventricular performance in long COVID-19 syndrome.<\/jats:p>","DOI":"10.3390\/jcm13144144","type":"journal-article","created":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T11:12:49Z","timestamp":1721128369000},"page":"4144","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Exercise Intolerance Is Associated with Cardiovascular Dysfunction in Long COVID-19 Syndrome"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5794-3089","authenticated-orcid":false,"given":"Angelos","family":"Vontetsianos","sequence":"first","affiliation":[{"name":"Rehabilitation Unit, 1st Respiratory Medicine Department, \u201cSotiria\u201d Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9595-6974","authenticated-orcid":false,"given":"Nikolaos","family":"Chynkiamis","sequence":"additional","affiliation":[{"name":"Rehabilitation Unit, 1st Respiratory Medicine Department, \u201cSotiria\u201d Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"},{"name":"Thorax Research Foundation, 11521 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Gounaridi","sequence":"additional","affiliation":[{"name":"3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Anagnostopoulou","sequence":"additional","affiliation":[{"name":"Rehabilitation Unit, 1st Respiratory Medicine Department, \u201cSotiria\u201d Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiana","family":"Lekka","sequence":"additional","affiliation":[{"name":"Rehabilitation Unit, 1st Respiratory Medicine Department, \u201cSotiria\u201d Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stavroula","family":"Zaneli","sequence":"additional","affiliation":[{"name":"Rehabilitation Unit, 1st Respiratory Medicine Department, \u201cSotiria\u201d Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4925-2332","authenticated-orcid":false,"given":"Nektarios","family":"Anagnostopoulos","sequence":"additional","affiliation":[{"name":"Rehabilitation Unit, 1st Respiratory Medicine Department, \u201cSotiria\u201d Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8079-0599","authenticated-orcid":false,"given":"Evangelos","family":"Oikonomou","sequence":"additional","affiliation":[{"name":"3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manolis","family":"Vavuranakis","sequence":"additional","affiliation":[{"name":"3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0138-5582","authenticated-orcid":false,"given":"Nikoletta","family":"Rovina","sequence":"additional","affiliation":[{"name":"1st Respiratory Medicine Department, \u201cSotiria\u201d Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9708-3241","authenticated-orcid":false,"given":"Andriana","family":"Papaioannou","sequence":"additional","affiliation":[{"name":"Rehabilitation Unit, 1st Respiratory Medicine Department, \u201cSotiria\u201d Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6852-1553","authenticated-orcid":false,"given":"Georgios","family":"Kaltsakas","sequence":"additional","affiliation":[{"name":"Rehabilitation Unit, 1st Respiratory Medicine Department, \u201cSotiria\u201d Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"},{"name":"Lane Fox Respiratory Service, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London SE1 7EH, UK"},{"name":"Centre of Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London, London SE1 1UL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1719-7220","authenticated-orcid":false,"given":"Nikolaos","family":"Koulouris","sequence":"additional","affiliation":[{"name":"Rehabilitation Unit, 1st Respiratory Medicine Department, \u201cSotiria\u201d Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4830-7207","authenticated-orcid":false,"given":"Ioannis","family":"Vogiatzis","sequence":"additional","affiliation":[{"name":"Rehabilitation Unit, 1st Respiratory Medicine Department, \u201cSotiria\u201d Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"},{"name":"Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University Newcastle, Newcastle upon Tyne NE1 8ST, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,16]]},"reference":[{"key":"ref_1","unstructured":"Johns Hopkins University (2023, October 03). 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