ArticleCirculation. Heart failure2018
Pulmonary Capillary Wedge Pressure Patterns During Exercise Predict Exercise Capacity and Incident Heart Failure.
Article in Circulation. Heart failure, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 132 papers, 3 of them syntheses that pooled it.
What it found
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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
132 citing papers in PubMed, 3 syntheses or guidelines pooled it, 243 citations in OpenAlex.
- Normal limits for the right ventricle-pulmonary circulation exercise echocardiography: a meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2026Pooled it
- Exercise haemodynamics in heart failure with preserved ejection fraction: a systematic review and meta-analysis.ESC heart failure · 2022Pooled it
- Diagnostic, prognostic and differential-diagnostic relevance of pulmonary haemodynamic parameters during exercise: a systematic review.The European respiratory journal · 2022Pooled it
- Trimetazidine in heart failure with preserved ejection fraction: a randomized controlled cross-over trial.ESC heart failure · 2023Trial
- Cardiac and Metabolic Effects of Dapagliflozin in Heart Failure With Preserved Ejection Fraction: The CAMEO-DAPA Trial.Circulation · 2023Trial
- Pressure-flow responses to exercise in aortic stenosis, mitral regurgitation and diastolic dysfunction.Heart (British Cardiac Society) · 2022Trial
- Latent Pulmonary Vascular Disease May Alter the Response to Therapeutic Atrial Shunt Device in Heart Failure.Circulation · 2022Trial
- The haemodynamic basis of lung congestion during exercise in heart failure with preserved ejection fraction.European heart journal · 2019Trial
- Trial
- Haemodynamic response to exercise in patients with hypertrophic cardiomyopathy without left ventricular outflow tract obstruction.Heart (British Cardiac Society) · 2026Observational
- Left ventricular transmural pressure and ventilatory inefficiency during exercise in advanced heart failure.ESC heart failure · 2026Article
- Exercise-Induced Pulmonary Hypertension: What Is New?Journal of cardiovascular development and disease · 2026Review
- HFpEF and MASLD: converging mechanisms and clinical implications.Nature reviews. Cardiology · 2026Review
- Dyspnea in heart failure: pathophysiology, clinical assessment, and evidence from clinical trials.Heart failure reviews · 2026Review
- Heart failure and preserved ejection fraction: pathophysiology, clinical assessment, and management of exercise intolerance.European heart journal · 2026Review
- Progression From Exercise-Induced to Resting Left Atrial Hypertension in HFpEF: Impact of Reduced Atriopulmonary Compliance.JACC. Heart failure · 2026Observational
- Metabolic inflexibility across heart failure phenotypes: mechanisms and type-specific therapeutic implications.Apoptosis : an international journal on programmed cell death · 2026Review
- Multi-Organ Physiologic Deficits During Exercise Identify Clinical and Molecular Predisposition to Heart Failure with Preserved Ejection Fraction.Circulation · 2026Article
- Heart failure with preserved ejection fraction for the clinician - highlights from the 5th annual Charleston HFpEF conference.Heart failure reviews · 2026Article
- Invasive haemodynamic validation of an artificial intelligence echocardiographic tool for detecting heart failure with preserved ejection fraction.ESC heart failure · 2026Article
72 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
Abstract
backgroundSingle measurements of left ventricular filling pressure at rest lack sensitivity for identifying heart failure with preserved ejection fraction (HFpEF) in patients with dyspnea on exertion. We hypothesized that exercise hemodynamic measurements (ie, changes in pulmonary capillary wedge pressure [PCWP] indexed to cardiac output [CO]) may more sensitively differentiate HFpEF and non-HFpEF disease states, reflect aerobic capacity, and forecast heart failure outcomes in individuals with normal PCWP at rest. METHODS AND
resultsWe studied 175 patients referred for cardiopulmonary exercise testing with hemodynamic monitoring: controls (n=33), HFpEF with resting PCWP≥15 mm Hg (n=32), and patients with dyspnea on exertion with normal resting PCWP and left ventricular ejection fraction (DOE-nlrW; n=110). Across 1835 paired PCWP-CO measurements throughout exercise, we used regression techniques to define normative bounds of "PCWP/CO slope" in controls and tested the association of PCWP/CO slope with exercise capacity and composite cardiac outcomes (defined as cardiac death, incident resting PCWP elevation, or heart failure hospitalization) in the DOE-nlrW group. Relative to controls (PCWP/CO slope, 1.2±0.4 mm Hg/L/min), patients with HFpEF had a PCWP/CO slope of 3.4±1.9 mm Hg/L/min. We used a threshold (2 SD above the mean in controls) of 2 mm Hg/L/min to define abnormal. PCWP/CO slope >2 in DOE-nlrW patients was common (n=45/110) and was associated with reduced peak Vo
conclusionsElevated PCWP/CO slope during exercise (>2 mm Hg/L/min) is common in DOE-nlrW and predicts exercise capacity and heart failure outcomes. These findings suggest that current definitions of HFpEF based on single measures during rest are insufficient and that assessment of exercise PCWP/CO slope may refine early HFpEF diagnosis.
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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.