Evidence map›Paper›PMID 40578265›Full record

Trial reportJACC. Heart failure2025

Heart-Lung Interactions in HFpEF: Dynamic Hyperinflation and Exercise PCWP.

Michael G Leahy, Denis J Wakeham, James P MacNamara, Tiffany Brazile, Abidan Abulimiti, Christopher M Hearon, Mitchel Samels, Andrew R Tomlinson, Bryce N Balmain, Tony G Babb and 2 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JACC. Heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04068844 (Mechanisms of Exercise Intolerance in Heart Failure With Preserved Ejection Fraction), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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.

NCT04068844 nacompletednot on this map

Mechanisms of Exercise Intolerance in Heart Failure With Preserved Ejection Fraction

TypeinterventionalSponsorUniversity of Texas Southwestern Medical CenterRan2019 to 2026Enrolled93ConditionsHeart Failure, DiastolicArmsExercise training
3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
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

12 authors.

Michael G LeahyInstitute for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, Texas, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Denis J WakehamInstitute for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, Texas, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
James P MacNamaraInstitute for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, Texas, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Tiffany BrazileInstitute for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, Texas, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Abidan AbulimitiInstitute for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, Texas, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Christopher M HearonInstitute for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, Texas, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Mitchel SamelsInstitute for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, Texas, USA.
Andrew R TomlinsonInstitute for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, Texas, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Bryce N BalmainInstitute for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, Texas, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Tony G BabbInstitute for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, Texas, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Benjamin D LevineInstitute for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, Texas, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Satyam SarmaInstitute for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, Texas, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA. Electronic address: satyam.sarma@utsouthwestern.edu.

Funding

Targeting skeletal muscle to improve exercise capacity in heart failure with preserved ejection fraction.P01HL137630 · NHLBI · UT SOUTHWESTERN MEDICAL CENTER · PI TONY G BABB · 2022 to 2023
$9.1M
NHLBI NIH HHS P01 HL137630
6 · The paper itself

Abstract

backgroundPatients with heart failure with preserved ejection fraction (HFpEF) are characterized by an exaggerated rise in pulmonary capillary wedge pressure (PCWP) with exercise compared with healthy similar-aged adults. Due to the multisystemic effects of the disease, patients with HFpEF often experience expiratory flow limitation (EFL), thereby perpetuating dynamic hyperinflation (DH) and ventilation at a higher percentage of total lung volume. How lung mechanics and operational lung volume affect central hemodynamics in patients with HFpEF is not fully understood.

objectivesThe authors sought to characterize the association and correlation of DH and EFL on PCWP in adults with HFpEF during exercise.

methodsA total of 55 patients with HFpEF (71 ± 7 years of age, 70% female) were studied at rest and during 20-W and peak exercise on an upright semirecumbent cycle ergometer. Right atrial and mean pulmonary artery (mPAP) pressures as well as PCWP (via right heart catheterization), oxygen uptake (indirect calorimetry), cardiac output (direct Fick), and ventilation (flow-volume parameters) were measured at each timepoint. DH was defined as an increase in end-expiratory lung volume of ≥150 mL from rest as determined by repeated inspiratory capacity maneuvers.

resultsPCWP was greater in those with DH at 20-W exercise (DH 24 ± 6 mm Hg vs typical 18 ± 6; P = 0.033) and peak exercise (DH 44 ± 9 vs typical 31 ± 6 mm Hg; P = 0.002). The degree of dynamic inflation was modestly, but significantly associated with a greater PCWP at 20-W (r

conclusionsPatients with HFpEF that dynamically hyperinflate during exercise have greater PCWP as measured with reference to atmospheric pressure. The severity of hyperinflation scaled proportionally to higher exercise PCWP. Our findings suggest that the augmented exercise PCWP in patients with HFpEF may not be entirely attributed to ventricular stiffness, but also a consequence of increased intrathoracic pressure from dysfunctional ventilatory mechanics. (Mechanisms of Exercise Intolerance in Heart Failure With Preserved Ejection Fraction; NCT04068844).

Indexed as

ExerciseHeart FailureLungPulmonary Wedge PressureAgedCardiac OutputExercise TestExercise ToleranceFemaleHumansMaleMiddle AgedOxygen ConsumptionRespiratory MechanicsStroke Volumedynamic hyperinflationheart failure with preserved ejection fractionpulmonary capillary wedge pressurepulmonary vascular pressure

Identifiers

PMID40578265
PMCPMC12328072

What Socratic holds

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Read underepoch 390

Registered trials

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.