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J Cardiopulm Rehabil Prev . The Impact of Cardiopulmonary Rehabilitation on Ventriculoarterial Coupling in Post-Coronavirus Disease-2019 Patients

tetano

Editor, Senior Moderator
J Cardiopulm Rehabil Prev


. 2024 Aug 26.
doi: 10.1097/HCR.0000000000000885. Online ahead of print. The Impact of Cardiopulmonary Rehabilitation on Ventriculoarterial Coupling in Post-Coronavirus Disease-2019 Patients

Maria-Ioanna Gounaridi[SUP] 1 [/SUP], Nektarios Souvaliotis, Angelos Vontetsianos, Nikolaos Chynkiamis, Stamatios Lampsas, Panagiotis Theofilis, Artemis Anastasiou, Athina Goliopoulou, Ioanna Tzima, Ourania Katsarou, Petros Bakakos, Manolis Vavouranakis, Nikolaos Koulouris, Gerasimos Siasos, Evangelos Oikonomou



Affiliations
Abstract

Purpose: Coronavirus disease-2019 (COVID-19) affects the cardiovascular system even after the acute phase of the disease. Cardiopulmonary rehabilitation may improve post-COVID-19 symptoms. This study aims to evaluate the impact of a cardiopulmonary rehabilitation program after acute COVID-19 on arterial stiffness, left ventricular function, and ventriculoarterial coupling (VAC).
Methods: Forty-eight adults were examined 1 (T0) and 3-mo (T1) following recovery from COVID-19 and randomized 1:1 to participate or not in a 3-mo rehabilitation program. Matched subjects were enrolled as a non-COVID-19 group. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (PWV). Left ventricular (LV) systolic performance was evaluated with global longitudinal strain (GLS). The PWV/LV-GLS ratio was calculated as an index of VAC. High-sensitivity C reactive protein (hs-CRP) was measured.
Results: At T0, convalescent patients with COVID-19 had impaired PWV (P= .001) and reduced VAC (P= .001) compared to non-COVID-19 subjects. PWV (8.15 ± 1.37 to 6.55 ± 0.98 m/sec, P < .001) and LV-GLS (-19.67 ± 1.98 to -21.3 ± 1.93%, P < .001) improved only in convalescent patients with COVID-19 undergoing rehabilitation. Similarly, VAC was only improved in the rehabilitation group (-0.42 ± 0.11 to -0.31 ± 0.06 m · sec-1 ·%-1, P< .001). A significant improvement in VO2max was noted after rehabilitation (15.70 [13.05, 21.45] to 18.30 [13.95, 23.75] ml · kg-1 · min-1, P = .01). Finally, hs-CRP was improved in both groups with a significantly greater improvement in the rehabilitation group.
Conclusion: A 3-mo rehabilitation program in convalesced patients with COVID-19 enhances the recovery of arterial stiffness, left ventricular function, and VAC, highlighting the beneficial mechanisms of rehabilitation in this patient population.


 
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