VO2max Research Articles

The higher oxygen consumption during multiple short intervals is sex-independent and not influenced by skeletal muscle characteristics in well-trained cyclists.

It has been suggested that time spent at a high fraction of maximal oxygen consumption (% O2max) plays a decisive role for adaptations to interval training. However, previous studies examining how interval sessions should be designed to achieve a high % O2max have exclusively been performed in males. The present study compared the % O2max attained during three different 6×8 min interval protocols, in female (n=11; O2max, 62.5 (6.4)mL·min-1·kg-1) and male (n=8; O2max, 81.0 (5.2)mL·min-1·kg-1) cyclists. Mean power output during work intervals were identical across the three interval protocols, corresponding to the cyclist's 40 min maximal effort (PO40min): (1) 30 s intervals at 118% of PO40min interspersed with 15 s active recovery at 60% (30/15), (2) constant pace at 100% of PO40min (CON), and (3) altering between 60 s intervals at 110% and 60 s at 90% of PO40min (60/60). Additionally, the study explored whether the m. vastus lateralis characteristics of the cyclists (fiber type proportion, capillarization, and citrate synthase activity) were associated with the % O2max attained during the interval sessions. Overall, mean % O2max and time ≥90% of O2max were higher during 30/15 compared to CON (86.7 (10.1)% and 1123 (787) s versus 85.0 (10.4)% and 879 (779) s, respectively; both p≤0.01) and 60/60 (85.6 (10.0)% and 917 (745) s, respectively; both p≤0.05), while no difference was observed between 60/60 and CON (both p≥0.36). During interval sessions, % O2max and time ≥90% of O2max did not differ between sexes. Skeletal muscle characteristics were not related to % O2maxduring interval sessions. In conclusion, well-trained cyclists demonstratehighest % O2max during 30/15, irrespective of sex and skeletal muscle characteristics.

Aerobic capacity of healthy young men associated with muscle oxygen extraction rate of the vastus lateralis muscle.

The determinants of aerobic capacity are oxygen delivery by the cardiopulmonary system and oxygen extraction by the skeletal muscles. However, the impact of the oxygen extraction capacity of the skeletal muscle is unclear. This study aimed to examine the associations between aerobic capacity; muscle strength, endurance, mass, and quality; and oxygen extraction capacity. Twenty-seven healthy young men (mean age, 20.7 ± 0.8 years; body mass index, 21.6 ± 3.2 kg m-2) were recruited. The following parameters were determined: peak work rate (WR) and oxygen uptake (V˙O2) corrected for body mass using the cardiopulmonary exercise testing; muscle strength and endurance using isokinetic muscle testing; muscle mass using bioelectrical impedance; muscle quality (muscle echo intensity) using an ultrasound imaging device, and muscle oxygen extraction rate (MOER) using near-infrared spectroscopy. Multiple regression analysis was performed using WR/kg peak and V˙O2/kg peak as dependent variables and each assessment index as an independent variable. Multiple regression analysis with WR/kg peak as the dependent variable resulted in the adoption of SMI (β = -0.41, P = 0.036), muscle echo intensity (β=-0.45, P = 0.012) and ΔMOER (β = 0.73, P < 0.001) as significantly associated factors. Multiple regression analysis with V˙O2/kg peak as the dependent variable resulted in ΔMOER (β = 0.65, P = 0.001) being adopted as a significantly associated factor. These findings suggest that muscle oxygen extraction rate is associated with aerobic capacity. MOER is a useful indicator because it is not affected by body mass.

Cardiorespiratory Fitness and Sleep, but not Physical Activity, are Associated with Functional Connectivity in Older Adults.

Aging results in changes in resting state functional connectivity within key networks associated with cognition. Cardiovascular function, physical activity, sleep, and body composition may influence these age-related changes in the brain. Better understanding these associations may help clarify mechanisms related to brain aging and guide interventional strategies to reduce these changes. In a large (n = 398) sample of healthy community dwelling older adults that were part of a larger interventional trial, we conducted cross sectional analyses of baseline data to examine the relationships between several modifiable behaviors and resting state functional connectivity within networks associated with cognition and emotional regulation. Additionally, maximal aerobic capacity, physical activity, quality of sleep, and body composition were assessed. Associations were explored both through correlation and best vs. worst group comparisons. Greater cardiovascular fitness, but not larger quantity of daily physical activity, was associated with greater functional connectivity within the Default Mode (p = 0.008 r = 0.142) and Salience Networks (p = 0.005, r = 0.152). Better sleep (greater efficiency and fewer nighttime awakenings) was also associated with greater functional connectivity within multiple networks including the Default Mode, Executive Control, and Salience Networks. When the population was split into quartiles, the highest body fat group displayed higher functional connectivity in the Dorsal Attentional Network compared to the lowest body fat percentage (p = 0.011; 95% CI - 0.0172 to - 0.0023). These findings confirm and expand on previous work indicating that, in older adults, higher levels of cardiovascular fitness and better sleep quality, but not greater quantity of physical activity, total sleep time, or lower body fat percentage are associated with increased functional connectivity within key resting state networks.

Online and Face-to-Face Mat Pilates Training for Long COVID-19 Patients: A Randomized Controlled Trial on Health Outcomes

This study investigated the impacts of online and face-to-face Mat Pilates training in adults with persistent symptoms of long COVID on health outcomes. Forty-nine patients (52 ± 5.85 yr.) diagnosed with long COVID related to fatigue symptoms were randomly included in three groups: online Mat Pilates training (n = 16), face-to-face Mat Pilates training (n = 15), and a control group (n = 18) without training. Mat Pilates training was conducted three times a week for 12 weeks. Fatigue, functional capacity, anthropometrics, body composition, and cardiometabolic markers were assessed before and after the interventions. Two-factor Generalized Estimating Equation analyses identified significant differences with Bonferroni post hoc testing (p &lt; 0.05). After the intervention, only the face-to-face Mat Pilates training group had an improved total, physical and mental fatigue, trunk isometric strength, upper limb muscle endurance strength, and aerobic capacity (p &lt; 0.05). No changes were found in fat mass, muscle mass, free fat mass, % of fat, body mass, body mass index, or waist and hip circumferences. No significant changes were observed in blood glucose, glycated hemoglobin, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, or blood pressure (p &gt; 0.05). Our results highlight the potential of face-to-face Mat Pilates training as an effective intervention to mitigate persistent symptoms of long COVID related to fatigue and functional capacities.

The dual timescales of gait adaptation: Initial stability adjustments followed by subsequent energetic cost adjustments.

Gait adaptation during bipedal walking allows people to adjust their walking patterns to maintain balance, avoid obstacles, and avoid injury. Adaptation involves complex processes that function to maintain stability and reduce energy expenditure. However, the processes that influence walking patterns during different points in the adaptation period remain to be investigated. We recruited seventeen young adults ages 19-35 to assess split-belt adaptation. We also assessed individual aerobic capacity to understand how aerobic capacity influences adaptation. We analyzed step lengths, step length asymmetry (SLA), mediolateral margins of stability, positive, negative, and net mechanical work rates, as well as metabolic rate during adaptation. We used dual-rate exponential mixed-effects regressions to estimate the adaptation of each measure over two timescales. Our results indicate that mediolateral stability adapts over a single timescale in under 1 minute, while mechanical work rates, metabolic rate, step lengths, and step length asymmetry adapt over two distinct timescales, ranging from 3.5 to 11.2 minutes. We then regressed mediolateral margins of stability, net mechanical work rate, and metabolic rate on step length asymmetry during early and late adaptation phases to determine if stability drives early adaptation and energetic cost drives late adaptation. Stability predicted SLA during the initial rapid onset of adaptation, and mechanical work rate predicted SLA during the latter part of adaptation. These findings suggest that stability optimization may contribute to early gait changes and that mechanical work contributes to later changes during adaptation. A final sub-analysis assessed the effect of aerobic capacity on step length asymmetry adaptation. Aerobic capacity levels below 36 and above 43 ml/kg/min resulted in greater adaptation, underscoring the metabolic influences on gait adaptation. This study illuminates the complex interplay between biomechanical and metabolic factors in gait adaptation, shedding light on fundamental mechanisms underlying human locomotion.

Improved functional oral intake and exercise training attenuate decline in aerobic capacity following chemoradiotherapy in patients with esophageal cancer.

To investigate the impact of chemoradiotherapy on the physical fitness of patients with oesophageal cancer, and the clinical factors influencing it. A total of 67 participants successfully completed the study, with 18 of them engaging in supervised, in-hospital aerobic training at moderate intensity for a minimum of 20 sessions. Cardiopulmonary exercise testing, hand grip strength, body composition assessed via bioelectrical impedance analysis, patient-generated subjective global assessment, albumin, and the Functional Oral Intake Scale (FOIS) were evaluated before chemoradiotherapy and 6-8 weeks after its completion. Among the participants, cardiopulmonary fitness, hand grip strength, and phase angle of BC-BIA declined during chemoradiotherapy. Before and after chemoradiotherapy, V̇O2peak was 19.6 ± 4.4 and 17.4 ± 3.9 mL/min/kg respectively. The improvement in FOIS during chemoradiotherapy showed a positive correlation with changes in aerobic capacity. Additionally, exercise training was associated with attenuating the decline in aerobic capacity. Physical fitness deteriorated in patients with oesophageal cancer following chemoradiotherapy. Improvement in dysphagia helps maintain aerobic capacity. Additionally, exercise training has the potential to mitigate the decline. This discovery can serve as a reference for enhancing holistic care for patients with oesophageal cancer.

The effect of ischemic preconditioning on physical fitness and performance: a meta-analysis in healthy adults.

This meta-analysis aims to assess the impact of ischemic preconditioning (IPC) on physical fitness and performance, with a focus on its specific role in aerobic endurance, anaerobic endurance, explosive power and strength. Systematic searches were conducted across multiple databases (CNKI, CBM, Cochrane Library, Web of Science, PubMed, and Embase) up to September 6, 2023. We included studies that employed randomized controlled trial methods and sham ischemic preconditioning as the placebo group, and two reviewers independently screened literature and extracted data, using Review Manager 5.3 for analysis. This meta-analysis comprises 27 articles with 405 individuals, selected according to specified criteria. IPC significantly increased the blood lactate concentration after anaerobic speed endurance exercise (MD = 0.74, P = 0.03), the blood lactate concentration after incremental exercise (MD = 0.49, P = 0.04), the blood lactate concentration after muscular endurance exercise (MD = 0.68, P = 0.02), and the one-repetition maximum (MD = 1.38, P = 0.00001). Furthermore, it also significantly shortened completion time of the exercises primarily powered by glycolysis (MD = - 0.49, P = 0.01) and completion time of the exercises primarily powered by aerobic system (MD = - 7.27, P = 0.05), while marginally prolonging time to exhaustion (MD = 22.68, P = 0.08). However, IPC had no significant effect on maximum oxygen uptake, blood lactate concentration in fixed-load aerobic endurance exercise, peak power, or peak aerobic power, nor on completion time of the exercises primarily powered by phosphagen system. IPC could serve as a method to enhance physical performance, particularly for exercises primarily powered by aerobic system and glycolysis. Future research might explore how various cycles, locations, and widths of IPC affect the physical performance of participants with different activity levels.

Texas Dance for Health: Mixed Methods Pilot Study Promoting Physical Activity Among Older Adults

ABSTRACT Purpose Regular physical activity is essential for healthy aging. Less than 25% of older U.S. adults meet physical activity recommendations. The primary aim of Texas Dance for Health (D4H) was to determine whether older adults could achieve recommended aerobic physical activity intensity by dancing. Secondary aims were (1) determining participants’ attendance and enjoyment and (2) building a community-academic partnership. Design RE-AIM was the design framework for this mixed methods, nurse-facilitated, 8-week pilot study in the Spring of 2023. Weekly sessions comprised check-in, mini-lessons, dancing, and data collection. Participants danced sitting, standing, or both. Methods We divided each participant's pulse rate by maximum aerobic capacity to determine weekly activity intensity. Participants completed Physical Activity Enjoyment and Rating of Perceived Exertion scales after each session. Nurses collected attendance data and facilitated Table Talks (Weeks 4 and 8) to explore participants’ enjoyment and solicit feedback for improving and sustaining Dance for Health (D4H). Observations and field notes provided data regarding time, cost, logistics, and overall feasibility. Findings Across eight weeks, 68 to 84% of participants reached target heart rates. Nearly one-quarter of participants attended all sessions, with 65.7% attending > 5 sessions. At Week 8, the mean enjoyment score was 6.7 of 7. No adverse consequences occurred. Partners and participants identified strategies for sustainability. Conclusions D4H was an enjoyable way for older adults to reach recommended aerobic physical activity intensity. Feasible in costs and logistics, D4H design addressed key barriers to older adult physical activity. Clinical Evidence Dancing is an effective multicomponent fitness intervention for community dwelling older adults.

Effects of a 12-Week Mixed-Method Physical Exercise Program on Physical Fitness, Stress, Anxiety, and Quality of Life in Adolescents with Cerebral Palsy: A Case Series Study

Background/Objectives: Although the health benefits related to physical exercise for adolescents with cerebral palsy (CP) have been recognized, studies indicate that individuals with CP at school age are less involved in physical activities than their typical peers and are twice as likely to engage in sedentary behaviors. Therefore, our study aims to investigate the effects of a physical exercise program on physical fitness, stress, anxiety, and quality-of-life variables. Methods: A total of 15 teenagers with ambulatory CP (n = 8 boys, n = 7 girls, between 12 and 18 years old; M = 14.35; SD = 1.76) completed a 12-week program based on a mixed-method approach with face-to-face and live online activities. The outcome measures were physical fitness, stress, anxiety, and quality of life. Results: The 12-week exercise program resulted in gains in muscular strength, flexibility, and aerobic endurance tests, characterized by an increase in average walking speed and average VO2 max. There was also a significant change in the perception of emotional states of depression, anxiety, and stress reported by the participants. Conclusions: The program proved to be effective in physical fitness tests and perception of emotional states. Given the positive effects produced by the program, its design appears to meet the demands of adolescents with cerebral palsy.

Association Between Coronary Microvascular Dysfunction and Exercise Capacity in Dilated Cardiomyopathy.

Aerobic exercise capacity is an independent predictor of mortality in dilated cardiomyopathy (DCM), but the central mechanisms contributing to exercise intolerance in DCM are unknown. Characterize coronary microvascular function in DCM and determine if cardiovascular magnetic resonance (CMR) measures are associated with aerobic exercise capacity. Prospective case-control comparison of adults with DCM and matched controls. Adenosine-stress perfusion CMR to assess cardiac structure, function and automated inline myocardial blood flow quantification, and cardiopulmonary exercise testing (CPET) to determine peak VO2, were performed. Pre-specified multivariable linear regression, including key clinical and cardiac variables, was undertaken to identify independent associations with peak VO2. Sixty-six patients with DCM (mean age 61 years, 71% male) were propensity-matched to 66 controls (mean age 59 years, 71% male) based on age, sex, body mass index and diabetes. DCM patients had markedly lower peak VO2 (19.8±5.5 versus 25.2±7.3mL/kg/min; P<0.001). The DCM group had greater left ventricular (LV) volumes, lower systolic function, and had more fibrosis compared to controls. In the DCM group, there was similar rest but lower stress myocardial blood flow (1.53±0.49 versus 2.01±0.60mL/g/min; P<0.001) and lower MPR (2.69±0.84 versus 3.15±0.84; P=0.002). Multivariable linear regression demonstrated that LV ejection fraction, extracellular volume fraction and MPR, were independently associated with percentage predicted peak VO2 in DCM (R2=0.531, P<0.001). In comparison to controls, DCM patients have lower stress myocardial blood flow and MPR. In DCM, MPR, LV ejection fraction and fibrosis are independently associated with aerobic exercise capacity.

The effect of exercise training in people with pre-dialysis chronic kidney disease: a systematic review with meta-analysis.

Chronic kidney disease (CKD) is a global health issue with high mortality and economic costs. Exercise has potential benefits for pre-dialysis CKD management. This review examines the impact of exercise on CKD patients not on dialysis, focusing on improvement in various health parameters. Findings aim to inform the role of exercise in pre-dialysis CKD care. A systematic search of MEDLINE, EMBASE, the Cochrane Library of Controlled Trials, CINAHL, and SPORTDiscus, up to August 31, 2023, used key terms relating to pre-dialysis CKD and exercise. We pooled randomized controlled trials (RCTs) comparing exercise with usual care and conducted meta-analyses based on a random effects inverse variance model with the effect measure of mean difference. Of 1162 identified studies, 37 RCTs met the inclusion criteria including 1248 participants. Significant improvements were identified for peak VO2, mean difference [MD] (2.66mL/kg/min; 95% confidence interval [CI] 1.48, 3.83; p < 0.00001); the 6-min walk (MD 58.83m; 95% CI 35.26, 82.41; p < 0.00001), timed up and go (standardised mean difference -0.35; 95% CI -0.54, -0.15; p = 0.0006), 2-min step (MD 57.48 steps; 95% CI 27.80, 87.16; p = 0.0001), and sit to stand tests (MD 4.55 repetitions; 95% CI 1.49, 7.60; p = 0.004); short form [SF]-36 general health (MD 4.26; 95% CI 0.04, 8.47; p = 0.05); SF-36 mental component summary (MD 1.84; 95% CI 0.18, 3.51; p = 0.03); estimated glomerular filtration rate (MD 2.19mL/min/1.73 m2; 95% CI 0.97, 3.50; p = 0.001); serum cystatin-C (MD -0.06mg/L; 95% CI -0.11, -0.02; p = 0.004); resting heart rate (MD -1.97 bpm; 95% CI -3.84, -0.11; p = 0.04); triglycerides (MD -12.97mg/dL; 95% CI -17.30, -8.63; p < 0.00001); glycosylated haemoglobin (MD -0.25%; 95% CI -0.50, -0.01; p = 0.04); waist circumference (MD -3.12cm; 95% CI -4.37, -1.86; p < 0.00001); and interleukin-6 (MD -2.24pg/mL; 95% CI -3.87. -0.61; p = 0.007). Analysis revealed improvements in aerobic capacity, functional ability, quality of life, estimated glomerular filtration rate, serum cystatin-C, resting heart rate, waist circumference, triglyceride, glycosylated haemoglobin, and interleukin-6 levels.

Maintained cognitive gains after 10 weeks of cognitively engaging exercise via reducing body fat in overweight children

ABSTRACT This study aimed to determine whether the exercise-induced cognitive benefits persist after the interventions end and whether the persistence of cognitive gains following the intervention depends on the post-intervention exercise behaviour. Overweight children aged 10–12 years were enrolled in a 16-week afterschool program. During the first 10 weeks, children were randomised to receive the cognitively engaging movement games (CEMG) (N = 27) or the sedentary control (N = 27) interventions. During the subsequent 6-week post-intervention period, children self-selected either CEMG or sedentary activities daily. Perceptual discrimination performance, fitness, and body fat were measured before, immediately after, and 6-week after the intervention. Immediately after the intervention, the CEMG group improved aerobic capacity, muscular endurance, muscle power, body fat, and perceptual discrimination performance compared with the control group, and most of these benefits persisted after 6 weeks following the cessation of intervention. During the 6-week post-intervention period where CEMG and sedentary activities were both available, the CEMG group chose to engage in CEMG more frequently and with higher intensity on those days than the control group. The post-intervention exercise behaviours were positively related to the persistence of cognitive gains, and these associations were mediated through decreased body fat. Collectively, the 10-week CEMG intervention has positive effects not only on physical and cognitive outcomes, but also post-intervention self-selected exercise behaviours that may help maintain intervention-induced cognitive gains in overweight children. Future research controlling for factors impacting children’s behavioural choice and determining the differential effects of CEMG versus traditional exercise regimen is needed. Trial registration: Thai Clinical Trials Registry identifier: TCTR20220913006.

Executive functions in older adults with generalised anxiety disorder and healthy controls: Associations with heart rate variability, brain-derived neurotrophic factor, and physical fitness

Executive functions (EF) decline with age and this decline in older adults with generalised anxiety disorder (GAD) may be influenced by heart rate variability (HRV), brain-derived neurotrophic factor (BDNF), and physical fitness. Understanding these relationships is important for tailored treatments in this population. In this study, 51 adults with GAD (M age = 66.46, SD = 4.08) and 51 healthy controls (M age = 67.67, SD = 4.04) were assessed on cognitive inhibition (Stroop task), shifting (Trails part 4), flexibility (Wisconsin Card Sorting Test – Perseverative errors), working memory (Digit Span Backwards), IQ (Wechsler Abbreviated Scale of Intelligence), high frequency HRV, serum mature BDNF levels, and VO2 max. Results indicated that participants with GAD exhibited better cognitive inhibition compared to controls, with no general reduction in EF. Cognitive inhibition was predicted by gender, HRV, and BDNF levels, while cognitive shifting was predicted by gender and IQ, and cognitive flexibility and working memory by IQ. The enhanced cognitive inhibition in GAD participants might stem from maladaptive use of this function, characteristic of GAD, or protection from EF decline due to normal HRV. Increased BDNF levels, possibly due to good fitness, or compensatory mechanisms related to the disorder, might also play a role. These findings highlight the complexity of EF and related mechanisms in GAD, highlighting the need for interventions that consider both cognitive and physiological factors for optimal outcomes.

Functional and Social Recovery and Outcomes After Extracorporeal Membrane Oxygenation Support in COVID-19 Patients.

With the COVID pandemic, veno-venous (VV) extracorporeal membrane oxygenation (ECMO) was implanted in many patients around the world. Data regarding follow-up and recovery of patients who are placed on ECMO support after COVID-related acute respiratory distress syndrome (ARDS) or ARDS for any other reason are limited. In our study, we share the 1 year follow-up results and cardiopulmonary exercise test results of the discharged patients. Between April 2020 and February 2022, a total of 29 patients who were supported with VV ECMO due to coronavirus disease 2019 (COVID-19)-related ARDS, weaned successfully and discharged to home, and who came for regular follow-up after discharge from the hospital and underwent examinations were included in the study. A total of 35 patients weaned successfully. Thirty patients were discharged to home. Mean age of the patients was 37.1 (±10.3) and 16 (55%) patients were male. Mean ECMO support time was 49.1 (±22.3) days. One year of survival after discharge was 100%. None of the patients had mobilization problems at the end of 12 month follow-up. Mean VO2 max was 18.9 at the end of 12 months. Return to work rate was 90%. We think that starting rehabilitation in the early period, and including patients in post-ECMO follow-up programs by ECMO centers will contribute significantly not only to the functional recovery of patients but also to their integration into social life.

Decoding Ultramarathon: Muscle Damage as the Main Impediment to Performance.

The biological determinants of performance have been well described for running races up to and including the marathon (42.2km). Ultramarathon is more complex. Events range from 50 to 5000km in single or multiple stages, are contested in various environments and terrains, and force athletes to contend with diverse performance-limiting issues such as fueling, hydrating, gastrointestinal distress, muscle damage, and sleep deprivation. Ultramarathons are not simply "long marathons." Nevertheless, scientific developments over the past decade have inched us toward a more complete picture of the psychophysiological factors underpinning performance. In this Current Opinion, we argue that muscle damage and associated fatigue is the main impediment to performance in long ultramarathons; more performance-limiting than aerobic capacity, running economy, or gastrointestinal distress. To assess an athlete's tolerance to ultramarathon-specific muscle damage and fatigue, we propose a lab-based protocol comprising downhill running with pre- to post-exercise measures of muscle contractile function following electrical or magnetic stimulation of the quadriceps muscles or their central nerves, muscle damage biomarkers (e.g., creatine kinase, lactate dehydrogenase, and myoglobin), and muscle morphology via imaging techniques. We close by offering training and racing advice on mitigating the deleterious effects of muscle damage. The twofold aims of this paper are (i) to enable athletes and their teams to better prepare for races and (ii) to help medical personnel identify the physiological milieu most likely to afflict the ultrarunner.

Self-reported fatigue in people with post COVID-19: impact on functioning in daily life, and associated factors - a cross-sectional study.

To assess (i) the impact of self-reported fatigue on functioning in daily life, and (ii) the association with sociodemographics, physical capacity, and work ability among people with post-COVID-19. A cross-sectional study. Adults reporting post-COVID-19 symptoms for at least 2 months. Participants were recruited through social media and responded to an online survey between October 2021 and February 2022 regarding sociodemographics, COVID-19 symptoms, comorbidities, physical and mental fatigue, aerobic capacity, and work ability. Descriptive statistics and logistic regression analyses were used. A total of 614 participants (88% women, mean age 47 years, on average 13 months of symptoms) were included. A majority (≥ 84%) reported both physical fatigue and mental fatigue, according to the Fatigue Severity Scale and Mental Fatigue Scale. The fatigue impacted motivation, physical functioning, work, family, or social life, and increased sensitivity to stress and concentration difficulties. Among the factors, work ability had the strongest association with both physical fatigue and mental fatigue; odds ratio: 0.650 and 0.473, p < 0.001, respectively. This study found that self-reported fatigue is common among people with post-COVID-19, and negatively impacts functioning in daily life. To achieve a sustainable life and work situation, support and targeted rehabilitation interventions may be important.

Do Hemodynamic Definitions of Chronic Thromboembolic Pulmonary Hypertension Distinguish Between Distinct Phenotypes of Chronic Thromboembolic Pulmonary Disease?

Chronic thromboembolic pulmonary disease (CTEPD) is defined by chronic organized thrombi in the pulmonary circulation without or with pulmonary hypertension (CTEPH). The current definition of CTEPH has adopted lower mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) thresholds. Our aim was to identify its impact on the characterization of patients with CTEPD. All consecutive CTEPD patients referred for cardiopulmonary exercise testing (CPET) in a PH center were divided into four groups based on pulmonary haemodynamics. Group A: mPAP≤20 mmHg, Group B: mPAP>20 mmHg with PVR>2 and ≤3 WU, Group C: mPAP>20 mmHg with PVR>3 WU, Group D: mPAP>20 mmHg with PVR<2 WU (''unclassified''). We compared CPET, CT pulmonary angiography, and MRI data across the groups. There was mild aerobic capacity impairment, mild/moderate ventilatory inefficiency, and no significant cardiac limitation on CPET in all groups. However, patients in Groups A and D had better ventilatory efficiency and less oxygen desaturation on exercise due to lower dead-space ventilation. There was no difference in chronic pulmonary emboli burden and distribution, or resting RV function between the groups. Seventeen patients were reclassified as having ''CTEPH'' based on the current definition. No functional deterioration was noted within a median period of 13 months on repeat CPET. CTEPD patients with similar clot burden and RV function without or with mild/moderate PH displayed a similar pattern of cardiopulmonary limitation, except for ventilatory efficiency. The current definition for CTEPH may lead to reclassification of CTEPH in a considerable number of patients.

The Relationship between Inflammatory Factors, Hemoglobin, and VO2 Max in Male Amateur Long-Distance Cross-Country Skiers in the Preparation Period

Background: Identifying factors affecting heart health in amateur athletes can significantly impact their health and help them achieve high performance. The current knowledge of these predictors is insufficient. The purpose of this study was to identify the biochemical determinants of maximal oxygen uptake (VO2 max) in male amateur long-distance cross-country skiers (37.9 ± 6.58 years, 51.08 ± 4.61 VO2 max ml/kg/min) in the preparation period. Methods: In this cross-sectional study, a time trial test was used to determine VO2 max and venous blood via biochemical markers. Descriptive statistics and Pearson correlation were used to analyze the data. The regression model determined the predictors. Results: VO2 max was significantly correlated with nine moderate or weak variables. Two regression models (R2 = 0.94 and R2 = 0.9) each identified two determinants of VO2 max, hemoglobin (p &lt; 0.001) and C-reactive protein (p &lt; 0.001), as well as erythrocyte sedimentation (p &lt; 0.001) and platelets (p = 0.03). Only hemoglobin positive affected VO2 max. Conclusions: The results may indicate, in addition to results regarding hemoglobin concentration and its changes, the necessity to monitor the immune system, which may affect the capacity for amateur exercise. Biochemical monitoring is an essential tool for evaluating the individual adaptation to exercise and developing an effective training plan. The application of this knowledge can facilitate the achievement of optimal individual performance capabilities among cross-country skiing amateurs.

Predictive role of peak VO2 for short- and long-term major adverse cardiac events in patients with high cardiovascular risk.

The objective of this study was to assess the accuracy of VO2 measurements in predicting long-term major adverse cardiac events (MACEs) in patients with high cardiovascular risk. Based on a10-year atherosclerotic cardiovascular disease risk score, 333 patients with high cardiovascular risk were included in this retrospective analysis. The study endpoint was MACEs, comprising all-cause mortality, cardiovascular mortality, non-fatal myocardial infarction or stroke, and coronary revascularization. The study cohort was divided into two groups according to the frequency of MACE occurrence. Measurements of VO2 were assessed for the prediction of MACEs. The best predictive accuracy for 1‑year MACEs was determined to be aVO2 max value of ≥ 20.3 mL/kg/min, with 60% specificity and 60% sensitivity (area under the curve [AUC]: 0.61; 95% confidence interval [CI]: 0.51-0.71; p < 0.001), and for 5‑year MACEs it was ≥ 19.9 mL/kg/min, with 69% specificity and 64% sensitivity (AUC: 0.69; 95% CI: 0.62-0.76; p < 0.001). Multivariable Cox regression analysis, after adjusting for univariable factors, showed that VO2 max was independently associated with both short- and long-term MACEs in patients at high cardiovascular risk (hazard ratio [HR]: 0.900, 95% CI: 0.858-0.943, p < 0.001). According to the results of this pilot study, VO2 max can predict both short- and long-term MACEs in patients at high cardiovascular risk.

Impact of Multi-Professional Intervention on Health-Related Physical Fitness and Biomarkers in Overweight COVID-19 Survivors for 8 and 16 Weeks: A Non-Randomized Clinical Trial

Background/objectives: Considering the diverse symptomatology of COVID-19—ranging from mild to severe cases—multi-professional interventions are crucial for enhancing physical recovery, nutritional status, and mental health outcomes in affected patients. Thus, this study aimed to investigate the effects of such an intervention on health-related physical fitness and biomarkers in overweight COVID-19 survivors with varying degrees of symptom severity after 8 weeks and 16 weeks. Methods: This non-randomized clinical trial included 59 overweight COVID-19 survivors (32 males and 27 females) divided into three groups: mild (n = 31), moderate (n = 13), and severe/critical (n = 15). The participants underwent a multi-professional program and were assessed for anthropometric and body composition (primary outcome), as well as physical fitness and biochemical markers (secondary outcome) 8 and 16 weeks before the intervention. Results: After 8 weeks, time effects were observed for the maximum isometric handgrip strength (p &lt; 0.001), maximum isometric lumbar-traction strength (p = 0.01), flexibility (p &lt; 0.001), abdominal strength–endurance (p &lt; 0.001), the sit-and-stand test (p &lt; 0.001), maximum oxygen consumption (p &lt; 0.001), and distance covered in the 6 min walk test (p &lt; 0.001). Additionally, time effects were also observed for fat mass (p = 0.03), body fat percentage (p = 0.02), abdominal circumference (p = 0.01), total cholesterol (p &lt; 0.001), low-density lipoproteins (p &lt; 0.001), and glycated hemoglobin (p &lt; 0.001), with lower values after multi-professional interventions. After 16 weeks, the systolic and diastolic blood pressure showed significant reductions independently of the intervention group (p &lt; 0.001). Conclusion: These findings suggest that multi-professional interventions can provide substantial benefits for post-COVID-19 patients, regardless of the severity of their initial symptoms.