ArticleThe European respiratory journal2024
Prognostic relevance of exercise pulmonary hypertension: results of the multicentre PEX-NET Clinical Research Collaboration.
Article in The European respiratory journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed.
- Pulmonary haemodynamics and right heart function during exercise at high versus low altitude in patients with pulmonary vascular disease: a randomised crossover trial.Heart (British Cardiac Society) · 2025Trial
- Exercise testing for evaluating right ventricular (RV) function in pulmonary hypertension - A review.Lung India : official organ of Indian Chest Society · 2026Article
- Exercise-Induced Pulmonary Hypertension: What Is New?Journal of cardiovascular development and disease · 2026Review
- Heart failure and preserved ejection fraction: pathophysiology, clinical assessment, and management of exercise intolerance.European heart journal · 2026Review
- Article
- Update on pulmonary hypertension.Respiratory research · 2026Review
- 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
- Exercise haemodynamics in pulmonary hypertension - a prospective pressure-volume loop study on right ventricular adaptation and prognosis.European journal of heart failure · 2025Article
- Physiologic Phenotyping of Responses to Exercise and Activity in Heart Failure.Circulation research · 2025Review
- Physiologic relevance of the transpulmonary metabolome in connective tissue disease-associated pulmonary vascular disease.JCI insight · 2025Article
- Physical exercise for pulmonary arterial hypertension diagnosis and therapy.International journal of cardiology. Congenital heart disease · 2025Review
- Exercise Pulmonary Hypertension and Beyond: Insights in Exercise Pathophysiology in Pulmonary Arterial Hypertension (PAH) from Invasive Cardiopulmonary Exercise Testing.Journal of clinical medicine · 2025Review
- Definition, classification and diagnosis of pulmonary hypertension.The European respiratory journal · 2024Article
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37 authors.
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Abstract
backgroundExercise pulmonary hypertension (PH) was defined by a mean pulmonary arterial pressure (mPAP)/cardiac output (CO) slope >3 mmHg·min·L PATIENTS AND
methodsThe PEX-NET (Pulmonary Haemodynamics during Exercise Network) registry enrolled patients who underwent clinically indicated right heart catheterisations both at rest and ergometer exercise from 23 PH centres worldwide. In this retrospective analysis we included subjects with resting mPAP <25 mmHg and complete haemodynamic data at rest and exercise in the same body position. Mixed effects Cox proportional hazard models with random effect centre were applied to identify independent markers of prognosis among the haemodynamic parameters.
resultsWe included 764 patients (64% females; median (interquartile range) age 59 (46-69) years and mPAP 17 (14-20) mmHg). Median (range) observation time was 6.8 (0.1-15.9) years and 87 patients (11%) died during follow-up. After adjustment for age, sex, haemoglobin level and resting haemodynamics, CO (hazard ratio (HR) 0.85, 95% CI 0.77-0.93; p=0.001) and transpulmonary gradient (HR 1.04, 95% CI 1.00-1.08; p=0.044) at peak exercise and the mPAP/CO slope (HR 1.12, 95% CI 1.06-1.18; p<0.001) were the only independent predictors of prognosis. Patients with a mPAP/CO slope >3 mmHg·min·L
conclusionThe mPAP/CO slope is a robust and independent predictor of prognosis in patients with normal or mildly elevated resting PAP that provides prognostic information beyond resting haemodynamics and appears suitable to define exercise PH.
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