SynthesisThe European respiratory journal2022
Diagnostic, prognostic and differential-diagnostic relevance of pulmonary haemodynamic parameters during exercise: a systematic review.
Synthesis in The European respiratory journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
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Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it, 90 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
- Pulmonary arterial wedge pressure in healthy subjects: a meta-analysis.The European respiratory journal · 2024Pooled it
- Hemodynamic effects of cycle ergometry and low-intensity handgrip in patients with pulmonary hypertension.Frontiers in medicine · 2026Trial
- Pulmonary vascular reactivity in severe pulmonary hypertension associated with COPD.ERJ open research · 2026Article
- Exercise-Induced Pulmonary Hypertension: What Is New?Journal of cardiovascular development and disease · 2026Review
- Article
- Multimodal model for predicting exercise-induced pulmonary hypertension validated by invasive exercise hemodynamics: a prospective study.Respiratory research · 2026Article
- Long-Term Supervised Cardiac Rehabilitation After Balloon Pulmonary Angioplasty Improved Residual Exercise Pulmonary Hypertension in Patients With Chronic Thromboembolic Pulmonary Hypertension: A Two-Case Report.Pulmonary circulation · 2026Article
- Article
- Review
- Invasive Cardiopulmonary Exercise Testing Identifies Distinctive Hemodynamic Phenotypes in Patients with Interstitial Lung Disease and Exercise Intolerance.Respiration; international review of thoracic diseases · 2026Article
- Knowledge Gaps and Controversies on Cardiopulmonary Exercise Testing in the Assessment of Pulmonary Vascular Disease: An Official Statement of the Pulmonary Vascular Research Institute Exercise and Right Ventricular Function Task Force.Pulmonary circulation · 2026Article
- Advances in the imaging of pulmonary hypertension.International journal of cardiology. Congenital heart disease · 2025Review
- Exercise haemodynamics in pulmonary hypertension - a prospective pressure-volume loop study on right ventricular adaptation and prognosis.European journal of heart failure · 2025Article
- Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: Technical challenges and controversies.JHLT open · 2025Review
- Correlation between the extracellular volume fraction and hemodynamic parameters in light-chain cardiac amyloidosis patients.Quantitative imaging in medicine and surgery · 2025Article
- Acute effects of 50 mg additive oral sildenafil on invasive exercise haemodynamics in pulmonary vascular disease.ERJ open research · 2025Article
- Association of exercise-induced pulmonary hypertension with nailfold capillary density in systemic sclerosis: a single-center retrospective observational study.Arthritis research & therapy · 2025Observational
- Effects of Alcohol Septal Ablation on Exercise Hemodynamics, Symptoms, and Quality of Life in Obstructive Hypertrophic Cardiomyopathy.Journal of the American Heart Association · 2025Article
- Advancing Cardiovascular Risk Stratification and Functional Assessment: A Narrative Review of CPET and ESE Applications.Healthcare (Basel, Switzerland) · 2025Review
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe cardiopulmonary haemodynamic profile observed during exercise may identify patients with early-stage pulmonary vascular and primary cardiac diseases, and is used clinically to inform prognosis. However, a standardised approach to interpreting haemodynamic parameters is lacking.
methodsWe performed a systematic literature search according to PRISMA guidelines to identify parameters that may be diagnostic for an abnormal haemodynamic response to exercise and offer optimal prognostic and differential-diagnostic value. We performed random-effects meta-analyses of the normal values and report effect sizes as weighted mean±sd. Results of diagnostic and prognostic studies are reported descriptively.
resultsWe identified 45 eligible studies with a total of 5598 subjects. The mean pulmonary arterial pressure (mPAP)/cardiac output (CO) slope, pulmonary arterial wedge pressure (PAWP)/CO slope and peak cardiac index (or CO) provided the most consistent prognostic haemodynamic parameters during exercise. The best cut-offs for survival and cardiovascular events were a mPAP/CO slope >3 Wood units (WU) and PAWP/CO slope >2 WU. A PAWP/CO slope cut-off >2 WU best differentiated pre- from post-capillary causes of PAP elevation during exercise. Upper limits of normal (defined as mean+2sd) for the mPAP/CO and PAWP/CO slopes were strongly age-dependent and ranged in 30-70-year-old healthy subjects from 1.6 to 3.3 WU and 0.6 to 1.8 WU, respectively.
conclusionAn increased mPAP/CO slope during exercise is associated with impaired survival and an independent, prognostically relevant cut-off >3 WU has been validated. A PAWP/CO slope >2 WU may be suitable for the differentiation between pre- and post-capillary causes of PAP increase during exercise.
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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.