Evidence map›Paper›PMID 26792295›Full record

ReviewCurrent heart failure reports2016

The Nitrate-Nitrite-NO Pathway and Its Implications for Heart Failure and Preserved Ejection Fraction.

Julio A Chirinos, Payman Zamani

Abstract readReview
In one paragraph

Review in Current heart failure reports, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 1 pooled it
6.1field-weighted citation impact, top 3% 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.

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

35 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.

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  6. Gas entrapping materials for damage control.Advanced drug delivery reviews · 2026
    Review
  7. Dysregulated ProteinCirculation research · 2025
    Article
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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

2 authors at 1 institution in 1 country.

Julio A ChirinosUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. Julio.chirinos@uphs.upenn.edu.
Payman ZamaniUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
University of Pennsylvania · US

Funding

Training Program in Cardiovascular Biology and MedicineT32HL007843 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI THOMAS P. CAPPOLA, Sharlene M Day · 1996 to 2026
$11.0M
Efficacy of Potassium Nitrate in Heart Failure with Preserved Ejection FractionR01HL121510 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI CHIRINOS MEDINA, JULIO ALONSO · 2015 to 2019
$3.1M
Targeting Central Pulsatile Hemodynamics in Chronic Kidney DiseaseR56HL124073 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI CHIRINOS MEDINA, JULIO ALONSO · 2015 to 2015
$594k
Targeting Wave Reflections in Heart Failure with Preserved Ejection FractionR21AG043802 · NIA · UNIVERSITY OF PENNSYLVANIA · PI CHIRINOS MEDINA, JULIO ALONSO · 2013 to 2014
$440k
NHLBI NIH HHS R01 HL121510NHLBI NIH HHS R56 HL124073NHLBI NIH HHS T32 HL007843NIA NIH HHS R21 AG043802
6 · The paper itself

Abstract

The pathogenesis of exercise intolerance in patients with heart failure and preserved ejection fraction (HFpEF) is likely multifactorial. In addition to cardiac abnormalities (diastolic dysfunction, abnormal contractile reserve, chronotropic incompetence), several peripheral abnormalities are likely to be involved. These include abnormal pulsatile hemodynamics, abnormal arterial vasodilatory responses to exercise, and abnormal peripheral O2 delivery, extraction, and utilization. The nitrate-nitrite-NO pathway is emerging as a potential target to modify key physiologic abnormalities, including late systolic left ventricular (LV) load from arterial wave reflections (which has deleterious short- and long-term consequences for the LV), arterial vasodilatory reserve, muscle O2 delivery, and skeletal muscle mitochondrial function. In a recently completed randomized trial, the administration of a single dose of exogenous inorganic nitrate has been shown to exert various salutary arterial hemodynamic effects, ultimately leading to enhanced aerobic capacity in patients with HFpEF. These effects have the potential for both immediate improvements in exercise tolerance and for long-term "disease-modifying" effects. In this review, we provide an overview of key mechanistic contributors to exercise intolerance in HFpEF, and of the potential therapeutic role of drugs that target the nitrate-nitrite-NO pathway.

Indexed as

Exercise ToleranceHeart FailureHemodynamicsHumansMetabolic Networks and PathwaysNitratesNitric OxideNitritesOxygen ConsumptionStroke VolumeVasodilationNitratesNitric OxideNitritesAfterloadHeart failure with preserved ejection fractionInorganic nitrateMitochondriaTherapyWave reflections

Identifiers

PMID26792295
PMCPMC4755323
OpenAlexW2338563812

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.