Evidence map›Paper›PMID 32164435›Full record

ArticleCirculation. Heart failure2020

Mechanisms of Chronotropic Incompetence in Heart Failure With Preserved Ejection Fraction.

Satyam Sarma, Douglas Stoller, Joseph Hendrix, Erin Howden, Justin Lawley, Sheryl Livingston, Beverley Adams-Huet, Courtney Holmes, David S Goldstein, Benjamin D Levine

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02524145 (Determinants of Chronotropic Incompetence in Patients With Heart Failure and a Preserved Ejection Fraction), which is not on this map. Cited by 44 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 3 pooled it
7.6field-weighted citation impact, top 2% 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.

NCT02524145 nacompletednot on this map

Determinants of Chronotropic Incompetence in Patients With Heart Failure and a Preserved Ejection Fraction (HFpEF)

TypeinterventionalSponsorUniversity of Texas Southwestern Medical CenterRan2015 to 2017Enrolled40ConditionsHeart FailureArmsStatic Handgrip, Dexmedetomidine, Glycopyrrolate, Isoproterenol
3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 83 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Article
  6. Article
  7. Restoration of mitochondrial CaJournal of molecular and cellular cardiology · 2026
    Article
  8. Article
  9. Review
  10. Article
  11. Review
  12. Article
  13. Review
  14. Review
  15. Article
  16. Prognostic value of heart rate and oxygen pulse response in heart failure with left ventricular ejection fraction over 40.Clinical research in cardiology : official journal of the German Cardiac Society · 2024
    Article
  17. Review
  18. Article
  19. Heart failure with preserved ejection fraction.Nature reviews. Disease primers · 2024
    Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 3 countries.

Satyam SarmaInstitute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (S.S., D.S., S.L., B.D.L.).
Douglas StollerInstitute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (S.S., D.S., S.L., B.D.L.).
Joseph HendrixDepartment of Anesthesiology (J.H.), University of Texas Southwestern Medical Center Dallas.
Erin HowdenBaker Heart and Diabetes Institute, Melbourne, Australia (E.H.).
Justin LawleyUniversity of Innsbruck, Department Sport Science, Innsbruck, Austria (J.L.).
Sheryl LivingstonInstitute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (S.S., D.S., S.L., B.D.L.).
Beverley Adams-HuetDepartment of Population and Data Sciences (B.A.-H.), University of Texas Southwestern Medical Center Dallas.
Courtney HolmesAutonomic Medicine Section (formerly Clinical Neurocardiology Section), CNP/DIR/NINDS, National Institutes of Health, Bethesda, MD (C.H., D.S.G.).
David S GoldsteinAutonomic Medicine Section (formerly Clinical Neurocardiology Section), CNP/DIR/NINDS, National Institutes of Health, Bethesda, MD (C.H., D.S.G.).
Benjamin D LevineInstitute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (S.S., D.S., S.L., B.D.L.).
Texas Health Dallas · USNational Institutes of Health · USBaker Heart and Diabetes Institute · AUSouthwestern Medical Center · USThe University of Texas Southwestern Medical Center · USUniversität Innsbruck · AT

Funding

Aging Fitness & Failure: Mechanisms of Diastolic DysfunctionR01AG017479 · NIA · UT SOUTHWESTERN MEDICAL CENTER · PI LEVINE, BENJAMIN D · 2001 to 2016
$7.8M
NIA NIH HHS R01 AG017479
6 · The paper itself

Abstract

backgroundChronotropic incompetence is common in heart failure with preserved ejection fraction (HFpEF) and is associated with impaired aerobic capacity. We investigated the integrity of cardiac β-receptor responsiveness, an important mechanism involved in exertional increases in HR, in HFpEF and control subjects.

methodsThirteen carefully screened patients with HFpEF and 13 senior controls underwent exercise testing and graded isoproterenol infusion to quantify cardiac β-receptor-mediated HR responses. To limit autonomic neural influences on heart rate (HR) during isoproterenol, dexmedetomidine and glycopyrrolate were given. Isoproterenol doses were increased incrementally until HR increased by 30 beats per minute. Plasma levels of isoproterenol at each increment were measured by liquid chromatography with electrochemical detection and plotted against HR.

resultsPeak VO

conclusionsContrary to our hypothesis, patients with HFpEF displayed impaired cardiac β-receptor sensitivity compared with senior controls. In the 7 out of 13 patients with HFpEF with age-appropriate β-receptor sensitivity, peak HR remained low, suggesting impaired sinus node β-receptor function may not fully account for low exercise HR response. Rather in some patients with HFpEF, chronotropic incompetence might reflect premature cessation of exercise before maximal sinus node activation. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02524145.

Indexed as

Exercise ToleranceHeart RateStroke VolumeVentricular Function, LeftAdaptation, PhysiologicalAdrenergic beta-AgonistsAgedCase-Control StudiesExercise TestFemaleHeart FailureHumansIsoproterenolMaleMiddle AgedOxygen ConsumptionAdrenergic beta-AgonistsIsoproterenolReceptors, Adrenergic, betaexerciseheart failureheart rateisoproterenol

Identifiers

PMID32164435
PMCPMC7347285
OpenAlexW3011986409

What OpenQuestion holds

Textmetadata
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.