Evidence map›Paper›PMID 36958742›Full record

ArticleThe European respiratory journal2023

Cardiopulmonary exercise testing during follow-up after acute pulmonary embolism.

Ioannis T Farmakis, Luca Valerio, Stefano Barco, Eva Alsheimer, Ralf Ewert, George Giannakoulas, Lukas Hobohm, Karsten Keller, Anna C Mavromanoli, Stephan Rosenkranz and 4 more

Abstract read
In one paragraph

Article in The European respiratory journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing 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

24 citing papers in PubMed.

  1. Observational
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  19. Functional limitations 3 and 12 months after venous thromboembolism: a cohort study.Research and practice in thrombosis and haemostasis · 2024
    Article
  20. 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

14 authors.

Ioannis T FarmakisCenter for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.ORCID 0000-0002-0586-6386
Luca ValerioCenter for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.ORCID 0000-0003-4466-0724
Stefano BarcoCenter for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.ORCID 0000-0002-2618-347X
Eva AlsheimerClinic for General and Interventional Cardiology and Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Ralf EwertClinic for Internal Medicine, Greifswald University Hospital, Greifswald, Germany.
George GiannakoulasDepartment of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID 0000-0001-7491-6319
Lukas HobohmCenter for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.ORCID 0000-0002-4312-0366
Karsten KellerCenter for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.ORCID 0000-0002-0820-9584
Anna C MavromanoliCenter for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Stephan RosenkranzDepartment of Cardiology, Heart Center at the University Hospital Cologne and Cologne Cardiovascular Research Center, Cologne, Germany.
Timothy A MorrisDivision of Pulmonary and Critical Care Medicine, University of California at San Diego, La Jolla, CA, USA.ORCID 0000-0002-5122-9193
Stavros V KonstantinidesCenter for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany Stavros.Konstantinides@unimedizin-mainz.de.ORCID 0000-0001-6359-7279
Matthias HeldDepartment of Pulmonary Medicine, KWM Missio Clinic, Würzburg, Germany.
Daniel DumitrescuClinic for General and Interventional Cardiology and Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiopulmonary exercise testing (CPET) may provide prognostically valuable information during follow-up after pulmonary embolism (PE). Our objective was to investigate the association of patterns and degree of exercise limitation, as assessed by CPET, with clinical, echocardiographic and laboratory abnormalities and quality of life (QoL) after PE.

methodsIn a prospective cohort study of unselected consecutive all-comers with PE, survivors of the index acute event underwent 3- and 12-month follow-ups, including CPET. We defined cardiopulmonary limitation as ventilatory inefficiency or insufficient cardiocirculatory reserve. Deconditioning was defined as peak O

resultsOverall, 396 patients were included. At 3 months, prevalence of cardiopulmonary limitation and deconditioning was 50.1% (34.7% mild/moderate; 15.4% severe) and 12.1%, respectively; at 12 months, it was 44.8% (29.1% mild/moderate; 15.7% severe) and 14.9%, respectively. Cardiopulmonary limitation and its severity were associated with age (OR per decade 2.05, 95% CI 1.65-2.55), history of chronic lung disease (OR 2.72, 95% CI 1.06-6.97), smoking (OR 5.87, 95% CI 2.44-14.15) and intermediate- or high-risk acute PE (OR 4.36, 95% CI 1.92-9.94). Severe cardiopulmonary limitation at 3 months was associated with the prospectively defined, combined clinical-haemodynamic end-point of "post-PE impairment" (OR 6.40, 95% CI 2.35-18.45) and with poor disease-specific and generic health-related QoL.

conclusionsAbnormal exercise capacity of cardiopulmonary origin is frequent after PE, being associated with clinical and haemodynamic impairment as well as long-term QoL reduction. CPET can be considered for selected patients with persisting symptoms after acute PE to identify candidates for closer follow-up and possible therapeutic interventions.

Indexed as

Exercise TestPulmonary EmbolismAcute DiseaseExercise ToleranceFollow-Up StudiesHumansProspective StudiesQuality of Life

Identifiers

PMID36958742
PMCPMC10249018

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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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 Socratic graph.