Evidence map›Paper›PMID 28039229›Full record

ArticleCirculation2017

Role of Diastolic Stress Testing in the Evaluation for Heart Failure With Preserved Ejection Fraction: A Simultaneous Invasive-Echocardiographic Study.

Masaru Obokata, Garvan C Kane, Yogesh N V Reddy, Thomas P Olson, Vojtech Melenovsky, Barry A Borlaug

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

Article in Circulation, 2017. 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 267 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
267citing papers in PubMed, 4 pooled it
26.7field-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.

NCT01418248 completednot on this map

Evaluation of Exercise Intolerance and Right Heart Function in Patients With Heart Failure and Pulmonary Vascular Disease

TypeobservationalSponsorMayo ClinicRan2011 to 2013Enrolled108ConditionsExercise Tolerance, Dyspnea, Heart Failure, Pulmonary Hypertension
NCT03854071 narecruitingnot on this mapstarted 2018, after this paper: background citation

Development of Novel Physiological CMR Methods in Health and Disease

TypeinterventionalSponsorSheffield Teaching Hospitals NHS Foundation TrustRan2018 to 2031Enrolled135ConditionsHeart Failure, Pulmonary Hypertension, Myocardial Infarction, Coronary Artery DiseaseArmsintravenous fluid challenge
3 · Its place in the literature

Who cites it

267 citing papers in PubMed, 4 syntheses or guidelines pooled it, 544 citations in OpenAlex.

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  14. 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
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207 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Masaru ObokataFrom Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic Rochester, MN (M.O., G.C.K., Y.N.V.R., T.P.O., B.A.B.); and IKEM - Institute for Clinical and Experimental Medicine, Department of Cardiology, Prague, Czech Republic (V.M.).
Garvan C KaneFrom Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic Rochester, MN (M.O., G.C.K., Y.N.V.R., T.P.O., B.A.B.); and IKEM - Institute for Clinical and Experimental Medicine, Department of Cardiology, Prague, Czech Republic (V.M.).
Yogesh N V ReddyFrom Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic Rochester, MN (M.O., G.C.K., Y.N.V.R., T.P.O., B.A.B.); and IKEM - Institute for Clinical and Experimental Medicine, Department of Cardiology, Prague, Czech Republic (V.M.).
Thomas P OlsonFrom Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic Rochester, MN (M.O., G.C.K., Y.N.V.R., T.P.O., B.A.B.); and IKEM - Institute for Clinical and Experimental Medicine, Department of Cardiology, Prague, Czech Republic (V.M.).
Vojtech MelenovskyFrom Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic Rochester, MN (M.O., G.C.K., Y.N.V.R., T.P.O., B.A.B.); and IKEM - Institute for Clinical and Experimental Medicine, Department of Cardiology, Prague, Czech Republic (V.M.).
Barry A BorlaugFrom Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic Rochester, MN (M.O., G.C.K., Y.N.V.R., T.P.O., B.A.B.); and IKEM - Institute for Clinical and Experimental Medicine, Department of Cardiology, Prague, Czech Republic (V.M.). borlaug.barry@mayo.edu.
Institute of Clinical and Experimental Medicine · CZ

Funding

Mayo Heart Failure Regional Clinical CenterU10HL110262 · NHLBI · MAYO CLINIC ROCHESTER · PI REDFIELD, MARGARET M · 2012 to 2018
$3.6M
HL-Inorganic Nitrite to Enhance Benefits from Exercise Training in Heart Failure with preserved Ejection FractionR01HL128526 · NHLBI · MAYO CLINIC ROCHESTER · PI BORLAUG, BARRY A. · 2016 to 2019
$2.4M
NHLBI NIH HHS R01 HL128526NHLBI NIH HHS U10 HL110262
6 · The paper itself

Abstract

backgroundDiagnosis of heart failure with preserved ejection fraction (HFpEF) is challenging and relies largely on demonstration of elevated cardiac filling pressures (pulmonary capillary wedge pressure). Current guidelines recommend use of natriuretic peptides (N-terminal pro-B type natriuretic peptide) and rest/exercise echocardiography (E/e' ratio) to make this determination. Data to support this practice are conflicting.

methodsSimultaneous echocardiographic-catheterization studies were prospectively conducted at rest and during exercise in subjects with invasively proven HFpEF (n=50) and participants with dyspnea but no identifiable cardiac pathology (n=24).

resultsN-Terminal pro-B type natriuretic peptide levels were below the level considered to exclude disease (≤125 pg/mL) in 18% of subjects with HFpEF. E/e' ratio was correlated with directly measured pulmonary capillary wedge pressure at rest (

conclusionsCurrently proposed HFpEF diagnostic guidelines on the basis of resting data are poorly sensitive. Adding exercise E/e' data improves sensitivity and negative predictive value but compromises specificity, suggesting that exercise echocardiography may help rule out HFpEF. These results question the accuracy of current approaches to exclude HFpEF on the basis of resting data alone and reinforce the value of exercise testing using invasive and noninvasive hemodynamic assessments to definitively confirm or refute the diagnosis of HFpEF. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique Identifier: NCT01418248.

Indexed as

AgedAged, 80 and overEchocardiographyExercise TestFemaleHeart FailureHemodynamicsHumansMaleMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsProspective StudiesStroke VolumeVentricular Function, LeftNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)diagnosisexerciseexercise testheart failure

Identifiers

PMID28039229
PMCPMC5330848
OpenAlexW2602132542

What OpenQuestion holds

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LicenceTDM
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.