Evidence map›Paper›PMID 39453363›Full record

Observational studyJournal of the American College of Cardiology2024

Clinical Implications of Pretest Probability of HFpEF on Outcomes in Precapillary Pulmonary Hypertension.

Yogesh N V Reddy, Robert P Frantz, Paul M Hassoun, Anna R Hemnes, Evelyn Horn, Jane A Leopold, Franz Rischard, Erika B Rosenzweig, Nicholas S Hill, Serpil C Erzurum and 6 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of the American College of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing 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

16 citing papers in PubMed.

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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

16 authors.

Yogesh N V ReddyDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Robert P FrantzDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Paul M HassounDivision of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Anna R HemnesDivision of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Evelyn HornPerkin Heart Failure Center, Division of Cardiology, Weill Cornell Medicine, New York, New York, USA.
Jane A LeopoldDivision of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Franz RischardDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson, Arizona, USA.
Erika B RosenzweigDepartment of Pediatrics and Medicine, Columbia University, New York, New York, USA.
Nicholas S HillDivision of Pulmonary, Critical Care, and Sleep Medicine, Tufts Medical Center, Boston, Massachusetts, USA.
Serpil C ErzurumLerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Gerald J BeckDepartment of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA.
J Emanuel FinetDepartment of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Christine L JellisDepartment of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Stephen C MathaiDivision of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
W H Wilson TangDepartment of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Barry A BorlaugDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: borlaug.barry@mayo.edu.

Funding

Pulmonary Hypertension in Left Heart DiseaseR01HL162828 · MAYO CLINIC ROCHESTER · 2025 to 2025
$790k
Mayo Clinic HeartShare Clinical CenterU01HL160226 · MAYO CLINIC ROCHESTER · 2025 to 2025
$281k
Peripheral Limitations in Pulmonary Hypertension and Effects of Muscle TrainingK23HL164901 · MAYO CLINIC ROCHESTER · 2025 to 2025
$168k
NHLBI NIH HHS K23 HL164901NHLBI NIH HHS R01 HL128526NHLBI NIH HHS R01 HL162828NHLBI NIH HHS U01 HL125175NHLBI NIH HHS U01 HL125177NHLBI NIH HHS U01 HL125205NHLBI NIH HHS U01 HL125208NHLBI NIH HHS U01 HL125212NHLBI NIH HHS U01 HL125215NHLBI NIH HHS U01 HL125218NHLBI NIH HHS U01 HL160226
6 · The paper itself

Abstract

backgroundPatients with group 1 pulmonary hypertension (PH) and risk factors for heart failure with preserved ejection fraction (HFpEF) demonstrate worse response to pulmonary vasodilator therapy. The mechanisms and optimal diagnostic approach to identify such patients remain unclear.

objectivesThe purpose of this study was to compare exercise capacity, cardiac function, and hemodynamic responses to provocative maneuvers among patients with group 1 PH based upon pretest probability of HFpEF.

methodsPretest probability for HFpEF was determined using the validated HFpEF-ABA algorithm based on age, body mass index, and history of atrial fibrillation among group 1 PH patients recruited to the multicenter PVDOMICS (Redefining Pulmonary Hypertension through Pulmonary Vascular Disease Phenomics) study. Functional capacity, quality of life, and dynamic pulmonary capillary wedge pressure (PCWP) responses were compared between those with low (<25%), intermediate (25%-74%), and high (≥75%) ABA score-based HFpEF probability.

resultsAmong 424 patients with group 1 PH, 54% (n = 228) had intermediate HFpEF probability and 15% (n = 64) had high HFpEF probability. Resting PCWP increased progressively with higher HFpEF probability (P < 0.0001), and patients with group 1 PH and high HFpEF probability had the greatest increases in PCWP with nitric oxide, fluid challenge, and exercise (P < 0.001 for all), changes that were comparable to patients with HFpEF with no pulmonary vascular disease (n = 194), but lower than those with HFpEF and combined precapillary and postcapillary PH. Left ventricular/atrial size, diastolic function, quality of life, 6-minute walk distance, and peak VO

conclusionsQuantifying pretest probability for HFpEF in patients with group 1 PH identifies a subset of patients with worse dynamic PCWP response indicative of subclinical left heart disease, with poorer functional status, quality of life, and survival. Further study in this group 1 PH subgroup is indicated to determine whether PH therapies are effective and safe, and also whether HFpEF-specific therapies can improve functional status and outcomes.

Indexed as

Heart FailureHypertension, PulmonaryStroke VolumeAgedExercise ToleranceFemaleHumansMaleMiddle AgedPulmonary Wedge PressureQuality of Lifeexercise hemodynamicsHFpEFpulmonary arterial hypertension

Identifiers

PMID39453363
PMCPMC11760158

What Socratic holds

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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.