ArticlePulmonary circulation2016
Unexplained exertional dyspnea caused by low ventricular filling pressures: results from clinical invasive cardiopulmonary exercise testing.
Article in Pulmonary circulation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
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.
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.
Who cites it
44 citing papers in PubMed, 84 citations in OpenAlex.
- Assessment of internal consistency reliability and concurrent validity of PROMISJournal of patient-reported outcomes · 2026Article
- Letter by Risbano Regarding Article "Mechanisms Behind Dyspnea in Preload Insufficiency".Circulation. Heart failure · 2026Article
- From fatigue to physiology: Submaximal 2-day cardiopulmonary exercise test and emerging standards in long COVID.Experimental physiology · 2026Article
- Impact of patient positioning on hemodynamic assessment: A comparison of supine and upright right heart catheterization.Physiological reports · 2025Article
- Extracardiac mechanisms of cardiac output affect unexplained dyspnea on exertion.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Invasive haemodynamic assessment in heart failure with preserved ejection fraction.ESC heart failure · 2025Review
- Hemodynamic responses at anaerobic threshold during exercise in preload insufficiency.European journal of clinical investigation · 2025Article
- Impact of exercise to treat postural orthostatic tachycardia syndrome: a systematic review.Frontiers in neurology · 2025Review
- Exercise in Postural Orthostatic Tachycardia Syndrome: Focus on Individualized Exercise Approach.Journal of clinical medicine · 2024Review
- New Challenges and Perspectives in Neurology and Autonomic Disorders: A Leap Forward.Journal of personalized medicine · 2024Article
- Cardiopulmonary and metabolic responses during a 2-day CPET in myalgic encephalomyelitis/chronic fatigue syndrome: translating reduced oxygen consumption to impairment status to treatment considerations.Journal of translational medicine · 2024Article
- Head-down tilt reduces the heart rate in postural tachycardia syndrome in acute setting: a pilot study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Article
- Use of invasive cardiopulmonary exercise testing to diagnose preload reserve failure in patients with liver disease.ESC heart failure · 2024Article
- Impact of body position on hemodynamic measurements during exercise: A tale of two bikes.Pulmonary circulation · 2024Article
- Differential cardiopulmonary haemodynamic phenotypes in PASC-related exercise intolerance.ERJ open research · 2024Article
- The role of torso stiffness and prediction in the biomechanics of anxiety: a narrative review.Frontiers in sports and active living · 2024Review
- Invasive Cardiopulmonary Exercise Testing Identifies Distinct Physiologic Endotypes in Postacute Sequelae of SARS-CoV-2 Infection.CHEST pulmonary · 2023Article
- Review
- Role of Tau protein in long COVID and potential therapeutic targets.Frontiers in cellular and infection microbiology · 2023Review
- Association of Cardiac Autonomic Responses with Clinical Outcomes of Myasthenia Gravis: Short-Term Analysis of the Heart-Rate and Blood Pressure Variability.Journal of clinical medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
To determine whether low ventricular filling pressures are a clinically relevant etiology of unexplained dyspnea on exertion, a database of 619 consecutive, clinically indicated invasive cardiopulmonary exercise tests (iCPETs) was reviewed to identify patients with low maximum aerobic capacity (V̇o2max) due to inadequate peak cardiac output (Qtmax) with normal biventricular ejection fractions and without pulmonary hypertension (impaired: n = 49, V̇o2max = 53% predicted [interquartile range (IQR): 47%-64%], Qtmax = 72% predicted [62%-76%]). These were compared to patients with a normal exercise response (normal: n = 28, V̇o2max = 86% predicted [84%-97%], Qtmax = 108% predicted [97%-115%]). Before exercise, all patients received up to 2 L of intravenous normal saline to target an upright pulmonary capillary wedge pressure (PCWP) of ≥5 mmHg. Despite this treatment, biventricular filling pressures at peak exercise were lower in the impaired group than in the normal group (right atrial pressure [RAP]: 6 [IQR: 5-8] vs. 9 [7-10] mmHg, P = 0.004; PCWP: 12 [10-16] vs. 17 [14-19] mmHg, P < 0.001), associated with decreased stroke volume (SV) augmentation with exercise (+13 ± 10 [standard deviation (SD)] vs. +18 ± 10 mL/m(2), P = 0.014). A review of hemodynamic data from 23 patients with low RAP on an initial iCPET who underwent a second iCPET after saline infusion (2.0 ± 0.5 L) demonstrated that 16 of 23 patients responded with increases in Qtmax ([+24% predicted [IQR: 14%-34%]), V̇o2max (+10% predicted [7%-12%]), and maximum SV (+26% ± 17% [SD]). These data suggest that inadequate ventricular filling related to low venous pressure is a clinically relevant cause of exercise intolerance.
Indexed as
Identifiers
What OpenQuestion holds
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.