Evidence map›Paper›PMID 40293436›Full record

ArticleCardiology2025

Associations of Small-Airway Disease with Exercise Intolerance and Long-Term Outcomes in Patients with Heart Failure and Reduced or Preserved Ejection Fraction.

Nobuaki Hamazaki, Daina Nagumo, Nobuaki Hamazaki, Kentaro Kamiya, Takashi Miki, Shuken Kobayashi, Kohei Nozaki, Takafumi Ichikawa, Masashi Yamashita, Shota Uchida and 7 more

Abstract read
In one paragraph

Article in Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Review
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

17 authors.

Nobuaki Hamazaki
Daina NagumoDepartment of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Nobuaki HamazakiDepartment of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan.
Kentaro KamiyaDepartment of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Takashi MikiDepartment of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Shuken KobayashiDepartment of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan.
Kohei NozakiDepartment of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan.
Takafumi IchikawaDepartment of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan.
Masashi YamashitaDepartment of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Shota UchidaDepartment of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan.
Takumi NodaDepartment of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Kensuke UenoDepartment of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Ken OguraDepartment of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Emi MaekawaDepartment of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Minako Yamaoka-TojoDepartment of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Atsuhiko MatsunagaDepartment of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Junya AkoDepartment of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSmall airway is reportedly more susceptible than central airways in heart failure (HF), which may cause poor outcomes. We investigated clinical significance of small-airway disease (SAD) on exercise intolerance and clinical events in patients with HF and reduced or preserved left ventricular ejection fraction (LVEF).

methodsWe studied consecutive patients with HF admitted for medical treatment and measured maximum mid-expiratory flow (MMEF) on spirometry and 6-min walking distance (6MWD) at hospital discharge. SAD and exercise intolerance were defined by MMEF relative to <60% of the predicted value and 6MWD <300 m, respectively. Endpoint was composite clinical events of all-cause death and/or HF readmission.

resultsAmong 1,016 studied patients, 478 (47.0%) had SAD, the prevalence of which was higher in patients with LVEF ≥40% than LVEF <40%. SAD correlated to 6MWD <300 m (adjusted odds ratio [aOR]: 4.23, 95% confidence interval [CI]: 2.49-7.19). This correlation was consistently observed in both LVEF <40% (aOR: 3.99, 95% CI: 1.59-9.98) and LVEF ≥40% (aOR: 4.50, 95% CI: 2.22-9.13). SAD also showed significant associations with high incidences of clinical events in all patients (adjusted hazard ratio [aHR]: 1.35, 95% CI: 1.05-1.72) and in LVEF <40% (aHR: 1.76, 95% CI: 1.21-2.54) but not in LVEF ≥40% (aHR: 1.10, 95% CI: 0.78-1.53).

conclusionThe prevalence of SAD is high in patients with HF, which is associated with exercise intolerance regardless of LVEF. Additionally, SAD may have a predictive significance for clinical events in these patients, especially in LVEF <40%.

Indexed as

Exercise ToleranceHeart FailureStroke VolumeAgedFemaleHumansMaleMiddle AgedPrevalenceExercise intoleranceHeart failureLeft ventricular ejection fractionMaximum mid-expiratory flowSmall-airway disease

Identifiers

PMID40293436
PMCPMC12500266

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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.