Evidence map›Paper›PMID 26100151›Full record

ArticleBMC cardiovascular disorders2015

Characterization of exercise limitations by evaluating individual cardiac output patterns: a prospective cohort study in patients with chronic heart failure.

Ruud F Spee, Victor M Niemeijer, Bart Wessels, Jasper P Jansen, Pieter F F Wijn, Pieter A F M Doevendans, Hareld M C Kemps

Abstract read
In one paragraph

Article in BMC cardiovascular disorders, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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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.

Ruud F SpeeDepartment of Cardiology, Máxima Medical Centre, De Run 4600, P.O. Box 7777, Veldhoven, 5500 MB, The Netherlands. r.spee@mmc.nl.
Victor M NiemeijerDepartment of Cardiology, Máxima Medical Centre, De Run 4600, P.O. Box 7777, Veldhoven, 5500 MB, The Netherlands. v.niemeijer@gmail.com.
Bart WesselsDepartment of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands. b.wessels@tue.nll.
Jasper P JansenDepartment of Clinical Physics and Clinical Informatics, Máxima Medical Centre Veldhoven, Veldhoven, The Netherlands. j.jansen@mmc.nl.
Pieter F F WijnDepartment of Clinical Physics and Clinical Informatics, Máxima Medical Centre Veldhoven, Veldhoven, The Netherlands. p.wijn@mmc.nl.
Pieter A F M DoevendansDepartment of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands. p.doevendans@umcutrecht.nl.
Hareld M C KempsDepartment of Cardiology, Máxima Medical Centre, De Run 4600, P.O. Box 7777, Veldhoven, 5500 MB, The Netherlands. h.kemps@mmc.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with chronic heart failure (CHF) suffer from exercise intolerance due to impaired central hemodynamics and subsequent alterations in peripheral skeletal muscle function and structure. The relative contribution of central versus peripheral factors in the reduced exercise capacity is still subject of debate. The main purpose was to investigate heterogeneity in the nature of exercise intolerance by evaluating individual cardiac output (Q) patterns. The secondary purpose was to evaluate whether patient and disease characteristics were associated with a central hemodynamic exercise limitation.

methodsSixty-four stable CHF patients performed a symptom limited incremental exercise test with respiratory gas analysis and simultaneous assessment of Q, using a radial artery pulse contour analysis method. A central hemodynamic exercise limitation was defined as a plateau or decline in Q from 90 to 100 % of exercise duration.

resultsData from 61 patients were analyzed. A central hemodynamic exercise limitation was observed in 21 patients (34 %). In these patients, a higher occurrence of a plateau/decrease in oxygen uptake (VO2) (52 % vs 23 %, p = 0.02), stroke volume (SV) (100 % vs. 75 %, p = 0.01) and chronotropic incompetence (31 % vs. 2.5 %, p = 0.01) was observed, while presence of a left bundle branch block (LBBB) occurred significantly less (19 % vs 48 %, p = 0.03) There was no difference in disease characteristics such as etiology, duration, NYHA class, mitral regurgitation or ischemia.

conclusionsThe study revealed considerable heterogeneity in the nature of exercise limitations between moderately impaired CHF patients. In one third of the study population a plateau or decrease in Q towards peak exercise was demonstrated, which is indicative of a central hemodynamic exercise limitation. A central hemodynamic exercise limitation was associated with an impairment to augment stroke volume and heart rate.

Indexed as

Cardiac OutputExercise ToleranceOxygen ConsumptionStroke VolumeAgedBundle-Branch BlockCohort StudiesExercise TestFemaleHeart FailureHumansMaleMiddle AgedProspective StudiesPulmonary Gas ExchangePulse Wave Analysis

Identifiers

PMID26100151
PMCPMC4476170

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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.