Evidence map›Paper›PMID 29856742›Full record

Trial reportPloS one2018

Exercise gas exchange in continuous-flow left ventricular assist device recipients.

Alessandro Mezzani, Massimo Pistono, Piergiuseppe Agostoni, Andrea Giordano, Marco Gnemmi, Alessandro Imparato, Pierluigi Temporelli, Ugo Corrà

Abstract readClinical Trial
In one paragraph

Trial report in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
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

7 citing papers in PubMed.

  1. Article
  2. Review
  3. Observational
  4. Review
  5. Article
  6. Observational
  7. Article
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

8 authors.

Alessandro MezzaniExercise Pathophysiology Laboratory, Cardiac Rehabilitation Division, Scientific Institute of Veruno IRCCS, Istituti Clinici Scientifici Maugeri Spa SB, Veruno (NO), Italy.ORCID 0000-0003-1595-6227
Massimo PistonoExercise Pathophysiology Laboratory, Cardiac Rehabilitation Division, Scientific Institute of Veruno IRCCS, Istituti Clinici Scientifici Maugeri Spa SB, Veruno (NO), Italy.
Piergiuseppe AgostoniCentro Cardiologico Monzino IRCCS and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy.
Andrea GiordanoBioengineering Service, Scientific Institute of Veruno IRCCS, Istituti Clinici Scientifici Maugeri Spa SB, Veruno (NO), Italy.
Marco GnemmiExercise Pathophysiology Laboratory, Cardiac Rehabilitation Division, Scientific Institute of Veruno IRCCS, Istituti Clinici Scientifici Maugeri Spa SB, Veruno (NO), Italy.
Alessandro ImparatoEchocardiography Laboratory, Cardiac Rehabilitation Division, Scientific Institute of Veruno IRCCS, Istituti Clinici Scientifici Maugeri Spa SB, Veruno (NO), Italy.
Pierluigi TemporelliEchocardiography Laboratory, Cardiac Rehabilitation Division, Scientific Institute of Veruno IRCCS, Istituti Clinici Scientifici Maugeri Spa SB, Veruno (NO), Italy.
Ugo CorràExercise Pathophysiology Laboratory, Cardiac Rehabilitation Division, Scientific Institute of Veruno IRCCS, Istituti Clinici Scientifici Maugeri Spa SB, Veruno (NO), Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Exercise ventilation/perfusion matching in continuous-flow left ventricular assist device recipients (LVAD) has not been studied systematically. Twenty-five LVAD and two groups of 15 reduced ejection fraction chronic heart failure (HFrEF) patients with peak VO2 matched to that of LVAD (HFrEF-matched) and ≥14 ml/kg/min (HFrEF≥14), respectively, underwent cardiopulmonary exercise testing with arterial blood gas analysis, echocardiogram and venous blood sampling for renal function evaluation. Arterial-end-tidal PCO2 difference (P(a-ET)CO2) and physiological dead space-tidal volume ratio (VD/VT) were used as descriptors of alveolar and total wasted ventilation, respectively. Tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio (TAPSE/PASP) and blood urea nitrogen/creatinine ratio were calculated in all patients and used as surrogates of right ventriculo-arterial coupling and circulating effective volume, respectively. LVAD and HFrEF-matched showed no rest-to-peak change of P(a-ET)CO2 (4.5±2.4 vs. 4.3±2.2 mm Hg and 4.1±1.4 vs. 3.8±2.5 mm Hg, respectively, both p >0.40), whereas a decrease was observed in HFrEF≥14 (6.5±3.6 vs. 2.8±2.0 mm Hg, p <0.0001). Rest-to-peak changes of P(a-ET)CO2 correlated to those of VD/VT (r = 0.70, p <0.0001). Multiple regression indicated TAPSE/PASP and blood urea nitrogen/creatinine ratio as independent predictors of peak P(a-ET)CO2. LVAD exercise gas exchange is characterized by alveolar wasted ventilation, i.e. hypoperfusion of ventilated alveoli, similar to that of advanced HFrEF patients and related to surrogates of right ventriculo-arterial coupling and circulating effective volume.

Indexed as

Exercise TestHeart-Assist DevicesPulmonary Gas ExchangeAgedBlood PressureCreatinineFemaleHeart FailureHumansMaleMiddle AgedNitrogenPulmonary ArteryUreaCreatinineNitrogenUrea

Identifiers

PMID29856742
PMCPMC5983474

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.