2023
Differential cardiopulmonary haemodynamic phenotypes in PASC-related exercise intolerance
Kahn P, Joseph P, Heerdt P, Singh I. Differential cardiopulmonary haemodynamic phenotypes in PASC-related exercise intolerance. ERJ Open Research 2023, 10: 00714-2023. PMID: 38348243, PMCID: PMC10860209, DOI: 10.1183/23120541.00714-2023.Peer-Reviewed Original ResearchInvasive cardiopulmonary exercise testingRight heart catheterizationPASC patientsExertional intoleranceCardiac outputPulmonary artery wedge pressurePeak VO 2Supranormal cardiac outputPeak exercise capacityCardiopulmonary exercise testingMaximal voluntary ventilationPost-acute sequelaeBody mass indexSystemic oxygen extractionMild acute illnessSARS-CoV-2Exercise hemodynamicsHFpEF patientsHFpEF phenotypeHeart catheterizationWedge pressureAcute illnessExercise capacityExercise testingHemodynamic abnormalitiesExercise Pathophysiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Postacute Sequelae of SARS-CoV-2 More in Common Than Not?
Joseph P, Singh I, Oliveira R, Capone C, Mullen M, Cook D, Stovall M, Squires J, Madsen K, Waxman A, Systrom D. Exercise Pathophysiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Postacute Sequelae of SARS-CoV-2 More in Common Than Not? CHEST Journal 2023, 164: 717-726. PMID: 37054777, PMCID: PMC10088277, DOI: 10.1016/j.chest.2023.03.049.Peer-Reviewed Original ResearchConceptsMyalgic encephalomyelitis/chronic fatigue syndromeME/CFSChronic fatigue syndromeSARS-CoV-2Fatigue syndromePostacute sequelaeCardiopulmonary exercise testingSystemic blood flowExercise pathophysiologyExertional intoleranceIntractable fatigueExercise testingAcute infectionPostexertional malaiseExercise intoleranceOrthostatic intoleranceVentilatory controlLong-term consequencesBlood flowClinical overlapSuch symptomsIntoleranceSequelaeCOVID-19Syndrome
2022
Short- and long-term noninvasive cardiopulmonary exercise assessment in previously hospitalised COVID-19 patients
Singh I, Joseph P. Short- and long-term noninvasive cardiopulmonary exercise assessment in previously hospitalised COVID-19 patients. European Respiratory Journal 2022, 61: 2201739. PMID: 36137592, PMCID: PMC9515479, DOI: 10.1183/13993003.01739-2022.Peer-Reviewed Original ResearchConceptsCOVID-19 patientsAcute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionNoninvasive cardiopulmonary exercise testingSyndrome coronavirus 2 infectionCoronavirus 2 infectionCardiopulmonary exercise testingCoronavirus disease 2019 (COVID-19) pandemicSARS-CoV-2Disease 2019 pandemicExercise testingGlobal healthcare systemsInterval improvementExercise assessmentAerobic capacityHealthcare systemPatientsHospitalisationWorld populationPopulationInfectionMonths
2021
Persistent Exertional Intolerance After COVID-19 Insights From Invasive Cardiopulmonary Exercise Testing
Singh I, Joseph P, Heerdt PM, Cullinan M, Lutchmansingh DD, Gulati M, Possick JD, Systrom DM, Waxman AB. Persistent Exertional Intolerance After COVID-19 Insights From Invasive Cardiopulmonary Exercise Testing. CHEST Journal 2021, 161: 54-63. PMID: 34389297, PMCID: PMC8354807, DOI: 10.1016/j.chest.2021.08.010.Peer-Reviewed Original ResearchConceptsInvasive cardiopulmonary exercise testingCardiopulmonary exercise testingCardiopulmonary diseaseExercise testingControl participantsPeak VOExertional limitationCOVID-19Greater ventilatory inefficiencyPeak cardiac indexSex-matched control participantsCohort of patientsSystemic oxygen extractionDead space ventilationOnly mild symptomsExertional intoleranceCardiac indexPulmonary hemodynamicsAcute infectionVentilatory inefficiencyExercise intolerancePathophysiologic mechanismsMild symptomsHyperventilatory responseOxygen extractionImpact of right ventricular work and pulmonary arterial compliance on peak exercise oxygen uptake in idiopathic pulmonary arterial hypertension
Messina CMS, Ferreira EVM, Singh I, Fonseca AXC, Ramos RP, Nery LE, Systrom DM, Oliveira RKF, Ota-Arakaki JS. Impact of right ventricular work and pulmonary arterial compliance on peak exercise oxygen uptake in idiopathic pulmonary arterial hypertension. International Journal Of Cardiology 2021, 331: 230-235. PMID: 33545265, DOI: 10.1016/j.ijcard.2021.01.027.Peer-Reviewed Original ResearchConceptsRV stroke work indexPulmonary arterial hypertensionRight heart catheterizationExercise right heart catheterizationIdiopathic pulmonary arterial hypertensionIdiopathic PAHCardiac outputPA complianceArterial hypertensionRight ventricularDynes/s/Mean pulmonary arterial pressurePeak exercise oxygen uptakePeak stroke volume indexPA wedge pressurePeak cardiac indexPulmonary vascular resistanceStroke volume indexStroke work indexCardiopulmonary exercise testingPulmonary arterial pressurePulmonary arterial complianceRight ventricular workAge-adjusted multivariate modelExercise oxygen uptake
2020
Diagnostic utility of sub‐maximum cardiopulmonary exercise testing in the ambulatory setting for heart failure with preserved ejection fraction
Oakland HT, Joseph P, Elassal A, Cullinan M, Heerdt PM, Singh I. Diagnostic utility of sub‐maximum cardiopulmonary exercise testing in the ambulatory setting for heart failure with preserved ejection fraction. Pulmonary Circulation 2020, 10: 1-10. PMID: 33282205, PMCID: PMC7691918, DOI: 10.1177/2045894020972273.Peer-Reviewed Original ResearchIsolated post-capillary pulmonary hypertensionPost-capillary pulmonary hypertensionCardiopulmonary exercise testRight heart catheterizationPulmonary vascular capacitanceVE/VCOPulmonary hypertensionEnd-tidal carbon dioxideEjection fractionHeart failureExercise testHeart catheterizationVascular capacitanceCombined preElevated left-sided filling pressuresLeft-sided filling pressuresGender-matched control subjectsOxygen uptake efficiency slopeCarbon dioxide slopeCardiopulmonary exercise testingPulmonary artery complianceEnd-tidal COAdjunct diagnostic toolMaximum oxygen uptakeGreater ventilatoryDynamic right ventricular function response to incremental exercise in pulmonary hypertension
Singh I, Oliveira RKF, Heerdt P, Brown MB, Faria‐Urbina M, Waxman AB, Systrom DM. Dynamic right ventricular function response to incremental exercise in pulmonary hypertension. Pulmonary Circulation 2020, 10: 1-8. PMID: 33062259, PMCID: PMC7534091, DOI: 10.1177/2045894020950187.Peer-Reviewed Original ResearchRight ventricle functionRight ventricle stroke work indexStroke work indexPulmonary hypertensionVentricle functionPeak oxygen uptakePeak VOIncremental exerciseArterial elastanceWork indexInvasive cardiopulmonary exercise testingGender-matched normal controlsExercise pulmonary hypertensionMaximum incremental exercisePulmonary arterial elastancePulmonary hypertension groupRight ventricle adaptationVentricular function responseCardiopulmonary exercise testingPulmonary hypertension patientsRight ventricle dysfunctionPulmonary arterial hypertensionOxygen uptakeArterial hypertensionHypertension group
2019
Dynamic right ventricular–pulmonary arterial uncoupling during maximum incremental exercise in exercise pulmonary hypertension and pulmonary arterial hypertension
Singh I, Rahaghi F, Naeije R, Oliveira R, Vanderpool RR, Waxman A, Systrom D. Dynamic right ventricular–pulmonary arterial uncoupling during maximum incremental exercise in exercise pulmonary hypertension and pulmonary arterial hypertension. Pulmonary Circulation 2019, 9: 1-10. PMID: 31218910, PMCID: PMC6643191, DOI: 10.1177/2045894019862435.Peer-Reviewed Original ResearchPulmonary arterial hypertensionExercise pulmonary hypertensionRV-PA couplingMaximum incremental exerciseRV-PA uncouplingPulmonary hypertensionExercise pHRV contractilityArterial hypertensionExercise capacityIncremental exerciseInvasive cardiopulmonary exercise testingReduced peak oxygen consumptionPressure-volume loop analysisPulmonary arterial elastanceCardiopulmonary exercise testingRight ventricular functionPeak oxygen consumptionAge-matched controlsEnd-systolic elastanceContractile reserveExercise testingRV functionSuch patientsVentricular function