Native T1 is independently associated with aerobic exercise capacity in long-term follow-up after mild initial COVID-19 disease (Impression COVID&Heart Study)
Abstract
Background Exercise intolerance is a common and incapacitating long-term consequence of coronavirus disease (COVID-19), even after mild acute illness. Cardiovascular magnetic resonance (CMR) studies have demonstrated persistent perimyocardial inflammatory abnormalities; however, their relationship with long-term aerobic capacity remains unclear. Methods In this prospective observational study, individuals without prior structural heart disease underwent standardized CMR, echocardiography, and cardiopulmonary exercise testing (CPET) at least 3 years after the initial COVID-19. The primary endpoint was the association between %-predicted peak oxygen consumption (VO₂peak) (age-sex-body mass index (BMI) adjusted, Study of Health in Pomerania (SHIP) https://doi.org/10.1007/s00103-012-1483-6) and imaging parameters. Secondary analyses included lactate measurements and sex-stratified models. Results A total of 132 participants (mean age 49±12 years; 68/132 (52%) male) were evaluated 48 months [interquartile range (IQR) 42–53] post-infection. Non-ischemic perimyocardial enhancement was present in 34/132 (26%), whereas two participants had an unrecognized ischemic scar. Male sex, higher BMI, lower age, and higher native T1 were associated with lower %-predicted VO₂peak in univariate models. In multivariate analysis, male sex, lower age, and higher native T1 (β = −0.25 per ms, 95% CI −0.40 to −0.10; p<0.001) remained independent predictors of lower %-predicted VO₂peak. In total,…
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