- pregnancy or breast-feeding. - present atrial fibrillation. - diagnosed with acute myocarditis. - health conditions that prevent participating in the exercise intervention - patients who cannot undergo vo2max (e.g. acute heart attack or unstable angina, aortic stenosis, acute endocarditis / pericarditis, uncontrolled high blood pressure, acute thromboembolism, severe heart failure, respiratory failure and uncontrolled acute decompensated diabetes mellitus or low blood sugar). - treatment with il-6 receptor antagonists (tocilizumab, kevzara) within the last month due to drug interference with the cardiopulmonary exercise adaptations.

- pregnancy or breast-feeding. - present atrial fibrillation. - diagnosed with acute myocarditis. - health conditions that prevent participating in the exercise intervention - patients who cannot undergo vo2max (e.g. acute heart attack or unstable angina, aortic stenosis, acute endocarditis / pericarditis, uncontrolled high blood pressure, acute thromboembolism, severe heart failure, respiratory failure and uncontrolled acute decompensated diabetes mellitus or low blood sugar). - treatment with il-6 receptor antagonists (tocilizumab, kevzara) within the last month due to drug interference with the cardiopulmonary exercise adaptations.