Evidence map›Paper›PMID 31493035›Full record

ArticleEuropean journal of applied physiology2019

Unexplained exertional intolerance associated with impaired systemic oxygen extraction.

Kathryn H Melamed, Mário Santos, Rudolf K F Oliveira, Mariana Faria Urbina, Donna Felsenstein, Alexander R Opotowsky, Aaron B Waxman, David M Systrom

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Article in European journal of applied physiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing 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

16 citing papers in PubMed.

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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.

Kathryn H MelamedDivision of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, University of California at Los Angeles, 10833 Le Conte Avenue, 43-229 CHS, Los Angeles, CA, 90095, USA. kmelamed@mednet.ucla.edu.ORCID http://orcid.org/0000-0003-0837-3488
Mário SantosDivision of Pulmonary and Critical Care Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
Rudolf K F OliveiraDivision of Respiratory Diseases, Dept of Medicine, Federal University of São Paulo (Unifesp), São Paulo, Brazil.
Mariana Faria UrbinaDivision of Pulmonary and Critical Care Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
Donna FelsensteinInfectious Disease Unit, Medical Services, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
Alexander R OpotowskyBoston Adult Congenital Heart Service, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.
Aaron B WaxmanDivision of Pulmonary and Critical Care Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
David M SystromDivision of Pulmonary and Critical Care Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.

Funding

NIH HHS U01HL125215-01
6 · The paper itself

Abstract

purposeThe clinical investigation of exertional intolerance generally focuses on cardiopulmonary diseases, while peripheral factors are often overlooked. We hypothesize that a subset of patients exists whose predominant exercise limitation is due to abnormal systemic oxygen extraction (SOE).

methodsWe reviewed invasive cardiopulmonary exercise test (iCPET) results of 313 consecutive patients presenting with unexplained exertional intolerance. An exercise limit due to poor SOE was defined as peak exercise (Ca-vO

resultsPrevalence of impaired SOE as the sole cause of exertional intolerance was 12.5% (32/257). At peak exercise, poor SOE and HV had less acidemic arterial blood compared to NL (pHa = 7.39 ± 0.05 vs. 7.38 ± 0.05 vs. 7.32 ± 0.02, p < 0.001), which was explained by relative hypocapnia (PaCO

conclusionsWe identified a cohort of patients whose exercise limitation is due only to systemic oxygen extraction, due to either an intrinsic abnormality of skeletal muscle mitochondrion, limb muscle microcirculatory dysregulation, or hyperventilation and left shift the oxyhemoglobin dissociation curve.

Indexed as

Anaerobic ThresholdCardiorespiratory FitnessExercise ToleranceAdultAgedExerciseFemaleHeart RateHumansMaleMiddle AgedPulmonary Gas ExchangePulmonary VentilationCardiopulmonary exercise testingChronic fatigue syndromeExertional intoleranceHyperventilationPoor systemic oxygen extraction

Identifiers

PMID31493035

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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.