Evidence map›Paper›PMID 24507172›Full record

ArticleThe American journal of cardiology2014

Skeletal muscle composition and its relation to exercise intolerance in older patients with heart failure and preserved ejection fraction.

Mark J Haykowsky, Erik J Kouba, Peter H Brubaker, Barbara J Nicklas, Joel Eggebeen, Dalane W Kitzman

2 registry-linked trialsOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 152 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
152citing papers in PubMed, 4 pooled it
11.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01113840 nacompletednot on this map

Exercise Conditioning in Elderly Patients With Heart Failure

TypeinterventionalSponsorWake Forest UniversityRan1993 to 2009Enrolled201ConditionsHeart FailureArmsExercise, Control
NCT03111017 nacompletednot on this mapstarted 2017, after this paper: background citation

Mechanisms and Management of Exercise Intolerance in Older Heart Failure Patients With Preserved Ejection Fraction

TypeinterventionalSponsorThe University of Texas at ArlingtonRan2017 to 2019Enrolled12ConditionsHeart Failure, DiastolicArmsExercise Training
3 · Its place in the literature

Who cites it

152 citing papers in PubMed, 4 syntheses or guidelines pooled it, 243 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
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  5. Muscle quality during cancer treatment and associations with health-related quality of life.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
    Trial
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  13. Observational
  14. Review
  15. Greater amounts of visceral adipose and lean body mass increase heart failure risk in older women.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Review

92 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Mark J HaykowskyFaculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
Erik J KoubaDepartment of Pathology, University of Alabama, Birmingham, Alabama.
Peter H BrubakerDepartment of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina.
Barbara J NicklasGerontology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Joel EggebeenCardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Dalane W KitzmanCardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Electronic address: dkitzman@wfubmc.edu.
Wake Forest University · USUniversity of Alabama at Birmingham · USUniversity of Alberta · CA

Funding

Wake Forest Claude D. Pepper OAIC - RenewalP30AG021332 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI Jamie Nicole Justice · 2002 to 2026
$36.4M
Exercise Intolerance in Older HFPEF PatientsR01AG018915 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2001 to 2019
$5.2M
Exercise Intolerance in Elderly Diastolic Heart FailureR37AG018915 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2005 to 2013
$3.4M
Effect of fat loss on functional and cardiovascular benefits of aerobic exerciseR01HL093713 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI NICKLAS, BARBARA J · 2009 to 2013
$3.4M
NHLBI NIH HHS R01 HL093713NIA NIH HHS P30 AG021332NIA NIH HHS P30AG021332NIA NIH HHS R01 AG018915NIA NIH HHS R37 AG018915NIA NIH HHS R37AG18915
6 · The paper itself

Abstract

Exercise intolerance is the primary chronic symptom in heart failure with preserved ejection fraction (HFpEF), the most common form of heart failure in older patients; however its pathophysiology is not well understood. Recent data suggest that peripheral factors such as skeletal muscle (SM) dysfunction may be important contributors. Therefore, 38 participants, 23 patients with HFpEF (69±7 years) and 15 age-matched healthy controls (HCs), underwent magnetic resonance imaging and cardiopulmonary exercise testing to assess for SM, intermuscular fat (IMF), subcutaneous fat, total thigh, and thigh compartment (TC) areas and peak exercise oxygen consumption (peak VO2). There were no significant intergroup differences in total thigh area, TC, subcutaneous fat, or SM. However, in the HFpEF versus HC group, IMF area (35.6±11.5 vs 22.3±7.6 cm2, p=0.01), percent IMF/TC (26±5 vs 20±5%, p=0.005), and the ratio of IMF/SM (0.38±0.10 vs 0.28±0.09, p=0.007) were significantly increased, whereas percent SM/TC was significantly reduced (70±5 vs 75±5, p=0.009). In multivariate analyses, IMF area (partial r=-0.51, p=0.002) and IMF/SM ratio (partial r=-0.45, p=0.006) were independent predictors of peak VO2 whereas SM area was not (partial r = -0.14, p=0.43). Thus, older patients with HFpEF have greater thigh IMF and IMF/SM ratio compared with HCs, and these are significantly related to their severely reduced peak VO2. These data suggest that abnormalities in SM composition may contribute to the severely reduced exercise capacity in older patients with HFpEF. This implicates potential targets for novel therapeutic strategies in this common debilitating disorder of older persons.

Indexed as

AgedEchocardiography, DopplerElectrocardiographyExercise TestExercise ToleranceFemaleFollow-Up StudiesHeart FailureHumansMagnetic Resonance ImagingMaleMuscle, SkeletalOxygen ConsumptionPrognosisSeverity of Illness IndexStroke Volume

Identifiers

PMID24507172
PMCPMC4282135
OpenAlexW1970508540

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.