Evidence map›Paper›PMID 29413366›Full record

SynthesisJACC. Heart failure2018

Relative Impairments in Hemodynamic Exercise Reserve Parameters in Heart Failure With Preserved Ejection Fraction: A Study-Level Pooled Analysis.

Ambarish Pandey, Rohan Khera, Bryan Park, Mark Haykowsky, Barry A Borlaug, Gregory D Lewis, Dalane W Kitzman, Javed Butler, Jarett D Berry

Open access · greenAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in JACC. Heart failure, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 3 pooled it
5.6field-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

47 citing papers in PubMed, 3 syntheses or guidelines pooled it, 78 citations in OpenAlex.

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  6. Peak OESC heart failure · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 1 country.

Ambarish PandeyDivision of Cardiology, Department of Internal Medicine, University of Texas Southwest Medical Center, Dallas, Texas.
Rohan KheraDivision of Cardiology, Department of Internal Medicine, University of Texas Southwest Medical Center, Dallas, Texas.
Bryan ParkDivision of Cardiology, Department of Internal Medicine, University of Texas Southwest Medical Center, Dallas, Texas.
Mark HaykowskyCollege of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas.
Barry A BorlaugDivision of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Gregory D LewisDivision of Cardiology, Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Dalane W KitzmanDepartment of Internal Medicine, Sections on Cardiovascular Medicine and Geriatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Javed ButlerDivision of Cardiology, Department of Internal Medicine, Stony Brook University School of Medicine, New York, New York.
Jarett D BerryDivision of Cardiology, Department of Internal Medicine, University of Texas Southwest Medical Center, Dallas, Texas. Electronic address: jarett.berry@utsouthwestern.edu.
The University of Texas Southwestern Medical Center · USHarvard University · USMayo Clinic · USSouthwestern Medical Center · USStony Brook University · USThe University of Texas at Arlington · USWake Forest University · US

Funding

Wake Forest Claude D. Pepper OAIC - RenewalP30AG021332 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI Jamie Nicole Justice · 2002 to 2026
$36.4M
UT Southwestern Center for Translational Medicine (UL1/KL2/TL1)UL1TR001105 · NCATS · UT SOUTHWESTERN MEDICAL CENTER · PI TOTO, ROBERT DANIEL · 2013 to 2017
$24.5M
REHAB-HF: A Trial of Rehabilitation Therapy in Older Acute Heart Failure PatientsR01AG045551 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2014 to 2018
$6.8M
Exercise Intolerance in Older HFPEF PatientsR01AG018915 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2001 to 2019
$5.2M
Training in Cardiovascular ResearchT32HL125247 · NHLBI · UT SOUTHWESTERN MEDICAL CENTER · PI JOSEPH A HILL · 2015 to 2026
$4.3M
Exercise Intolerance in Elderly Diastolic Heart FailureR37AG018915 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2005 to 2013
$3.4M
SPRINT - HeartR01HL107257 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2011 to 2014
$1.5M
NCATS NIH HHS UL1 TR001105NHLBI NIH HHS R01 HL107257NHLBI NIH HHS T32 HL125247NIA NIH HHS P30 AG021332NIA NIH HHS R01 AG018915NIA NIH HHS R01 AG045551NIA NIH HHS R37 AG018915
6 · The paper itself

Abstract

objectivesThe aim of this study was to compare the relative impairment in different exercise hemodynamic reserve parameters in patients with heart failure with preserved ejection fraction (HFpEF) and control patients using a study-level meta-analysis.

backgroundA cardinal manifestation of chronic HFpEF is severely decreased exercise capacity. Developing effective therapies for exercise intolerance in HFpEF requires optimal understanding of the factors underlying exercise intolerance.

methodsData were included from 17 unique cohorts that measured peak oxygen uptake and hemodynamic or echocardiographic parameters during exercise in patients with HFpEF and control subjects in this meta-analysis. Standardized mean differences (SMDs) in the exercise reserve (exercise - resting) measures of hemodynamic or echocardiographic parameters between the HFpEF and control groups were pooled in a random-effects meta-analysis.

resultsThe pooled analysis included 910 patients with HFpEF and 476 control subjects. In pooled analysis, patients with HFpEF had significantly lower peak oxygen uptake (SMD: -2.13; 95% confidence interval [CI]: -2.68 to -1.57). Among hemodynamic exercise reserve parameters, the largest impairment was observed in chronotropic response reserve (change in heart rate from rest to peak exercise; SMD: -1.87; 95% CI: -2.44 to -1.29), followed by exaggerated increase in pulmonary capillary wedge pressure with exercise (SMD: 1.78; 95% CI: 1.46 to 2.09). Significant abnormalities were also observed in the arteriovenous oxygen difference reserve and stroke volume reserve between the HFpEF and control groups.

conclusionsThe most consistent and severe hemodynamic reserve abnormalities observed in patients with HFpEF were impairment in chronotropic reserve and exaggerated increase in pulmonary capillary wedge pressure with exercise. These may be important targets for therapeutic strategies to improve exercise tolerance in patients with HFpEF.

Indexed as

Exercise TestExercise ToleranceHeart FailureHeart RateHumansStroke VolumeVentricular Function, Leftexercise hemodynamicsheart failure with preserved ejection fractionmeta-analysis

Identifiers

PMID29413366
PMCPMC8135913
OpenAlexW2791013668

What OpenQuestion holds

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Registered trials

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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.