Evidence map›Paper›PMID 24658015›Full record

ArticleAmerican journal of physiology. Heart and circulatory physiology2014

Skeletal muscle abnormalities and exercise intolerance in older patients with heart failure and preserved ejection fraction.

Dalane W Kitzman, Barbara Nicklas, William E Kraus, Mary F Lyles, Joel Eggebeen, Timothy M Morgan, Mark Haykowsky

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

Article in American journal of physiology. Heart and circulatory physiology, 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 216 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
216citing papers in PubMed, 4 pooled it
19.3field-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.

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
NCT05888688 recruitingnot on this mapstarted 2023, after this paper: background citation

The Imaging Assessment of Sarcopenia Across the Heart Failure Spectrum

Typeobservational_patient_registrySponsorUniversity of LeicesterRan2023 to 2026Enrolled80ConditionsHeart Failure, Sarcopenia, Heart Failure With Reduced Ejection Fraction, Heart Failure With Preserved Ejection Fraction
3 · Its place in the literature

Who cites it

216 citing papers in PubMed, 4 syntheses or guidelines pooled it, 328 citations in OpenAlex.

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  12. Beet the Best?Circulation research · 2018
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  20. Assessment of Exercise Intolerance and Evaluation for HFpEF: A Literature Review of Pathophysiology, Diagnosis, and Management.Pathophysiology : the official journal of the International Society for Pathophysiology · 2026
    Review

156 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

7 authors at 3 institutions in 2 countries.

Dalane W KitzmanCardiology Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina;
Barbara Nicklas
William E Kraus
Mary F Lyles
Joel Eggebeen
Timothy M Morgan
Mark Haykowsky
Wake Forest University · USDuke University · 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
WORKER PROTECTION AGAINST AIRBORNE INFLUENZA - A PILOT STUDYM01RR007122 · NCRR · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI HOLMES, ROSS P · 1992 to 2010
$35.2M
Resource Core 3 - Metabolomics CoreP30AG028716 · NIA · DUKE UNIVERSITY · PI CATHLEEN S COLON-EMERIC · 2006 to 2026
$24.6M
Exercise Intolerance in Older HFPEF PatientsR01AG018915 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2001 to 2019
$5.2M
Loss of fat tissue and functional responses to exercise in older, obese adultsR01AG020583 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI NICKLAS, BARBARA J · 2002 to 2013
$4.0M
Exercise Intolerance in Elderly Diastolic Heart FailureR37AG018915 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2005 to 2013
$3.4M
NCRR NIH HHS MO1-RR-07122NIA NIH HHS P30 AG021332NIA NIH HHS P30-AG-021332NIA NIH HHS P30 AG028716NIA NIH HHS P30-AG-028716NIA NIH HHS R01 AG018915NIA NIH HHS R01-AG-020583NIA NIH HHS R37 AG018915NIA NIH HHS R37-AG-18915
6 · The paper itself

Abstract

Heart failure (HF) with preserved ejection fraction (HFPEF) is the most common form of HF in older persons. The primary chronic symptom in HFPEF is severe exercise intolerance, and its pathophysiology is poorly understood. To determine whether skeletal muscle abnormalities contribute to their severely reduced peak exercise O2 consumption (Vo2), we examined 22 older HFPEF patients (70 ± 7 yr) compared with 43 age-matched healthy control (HC) subjects using needle biopsy of the vastus lateralis muscle and cardiopulmonary exercise testing to assess muscle fiber type distribution and capillarity and peak Vo2. In HFPEF versus HC patients, peak Vo2 (14.7 ± 2.1 vs. 22.9 ± 6.6 ml·kg(-1)·min(-1), P < 0.001) and 6-min walk distance (454 ± 72 vs. 573 ± 71 m, P < 0.001) were reduced. In HFPEF versus HC patients, the percentage of type I fibers (39.0 ± 11.4% vs. 53.7 ± 12.4%, P < 0.001), type I-to-type II fiber ratio (0.72 ± 0.39 vs. 1.36 ± 0.85, P = 0.001), and capillary-to-fiber ratio (1.35 ± 0.32 vs. 2.53 ± 1.37, P = 0.006) were reduced, whereas the percentage of type II fibers was greater (61 ± 11.4% vs. 46.3 ± 12.4%, P < 0.001). In univariate analyses, the percentage of type I fibers (r = 0.39, P = 0.003), type I-to-type II fiber ratio (r = 0.33, P = 0.02), and capillary-to-fiber ratio (r = 0.59, P < 0.0001) were positively related to peak Vo2. In multivariate analyses, type I fibers and the capillary-to-fiber ratio remained significantly related to peak Vo2. We conclude that older HFPEF patients have significant abnormalities in skeletal muscle, characterized by a shift in muscle fiber type distribution with reduced type I oxidative muscle fibers and a reduced capillary-to-fiber ratio, and these may contribute to their severe exercise intolerance. This suggests potential new therapeutic targets in this difficult to treat disorder.

Indexed as

Exercise ToleranceStroke VolumeAgedCapillariesCase-Control StudiesExerciseFemaleHeart FailureHumansMaleMicrocirculationMuscle, SkeletalOxygen Consumptionagingexerciseheart failure

Identifiers

PMID24658015
PMCPMC4010668
OpenAlexW2143676228

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.