Featured Publications
Pulmonary Capillary Wedge Pressure Patterns During Exercise Predict Exercise Capacity and Incident Heart Failure
Eisman A, Shah R, Dhakal B, Pappagianopoulos P, Wooster L, Bailey C, Cunningham T, Hardin K, Baggish A, Ho J, Malhotra R, Lewis G. Pulmonary Capillary Wedge Pressure Patterns During Exercise Predict Exercise Capacity and Incident Heart Failure. Circulation Heart Failure 2018, 11: e004750. PMID: 29695381, PMCID: PMC5937988, DOI: 10.1161/circheartfailure.117.004750.Peer-Reviewed Original ResearchConceptsHeart failure outcomesExercise capacityCardiac outcomesHeart failureLeft ventricular ejection fractionLeft ventricular filling pressureMeasure of left ventricular filling pressureComposite cardiac outcomeDefinitions of HFpEFExercise hemodynamic measurementsPeak VO<sub>2</sub>Ventricular ejection fractionAdverse cardiac outcomesVentricular filling pressureFailure outcomesCardiopulmonary exercise testingBody mass indexPredicting exercise capacityIncident heart failureDifferentiate HFpEFNon-HFpEFEjection fractionHFpEF diagnosisMm HgFollow-up
2020
Exercise Pulmonary Hypertension Predicts Clinical Outcomes in Patients With Dyspnea on Effort
Ho J, Zern E, Lau E, Wooster L, Bailey C, Cunningham T, Eisman A, Hardin K, Farrell R, Sbarbaro J, Schoenike M, Houstis N, Baggish A, Shah R, Nayor M, Malhotra R, Lewis G. Exercise Pulmonary Hypertension Predicts Clinical Outcomes in Patients With Dyspnea on Effort. Journal Of The American College Of Cardiology 2020, 75: 17-26. PMID: 31918830, PMCID: PMC7043927, DOI: 10.1016/j.jacc.2019.10.048.Peer-Reviewed Original ResearchConceptsExercise pulmonary hypertensionPulmonary artery pressurePulmonary hypertensionAbnormal pulmonary artery pressureCardiac outputChronic exertional dyspneaEvent-free survivalInvasive hemodynamic monitoringPredicting clinical outcomesBurden of PHCV event-free survivalCardiopulmonary exercise testingPredicting adverse eventsTargeted therapeutic interventionsPH subtypesExertional dyspneaPrognostic implicationsClinical outcomesAdverse eventsResting pHResponse to exerciseDeath eventsFollow-upHemodynamic assessmentArterial pressure
2019
Differential Clinical Profiles, Exercise Responses, and Outcomes Associated With Existing HFpEF Definitions
Ho J, Zern E, Wooster L, Bailey C, Cunningham T, Eisman A, Hardin K, Zampierollo G, Jarolim P, Pappagianopoulos P, Malhotra R, Nayor M, Lewis G. Differential Clinical Profiles, Exercise Responses, and Outcomes Associated With Existing HFpEF Definitions. Circulation 2019, 140: 353-365. PMID: 31132875, PMCID: PMC6684250, DOI: 10.1161/circulationaha.118.039136.Peer-Reviewed Original ResearchConceptsHeart Failure Society of AmericaEuropean Society of CardiologyClinical profileHeart failureCardiovascular outcomesComprehensive cardiopulmonary exercise testingHemodynamic profile of patientsChronic exertional dyspneaDefinitions of HFpEFExercise responseSuspected heart failureAmerican College of Cardiology/American Heart AssociationInvasive hemodynamic monitoringPhenotype of patientsIncidence of cardiovascular outcomesCardiopulmonary exercise testingProfile of patientsClinical trial criteriaSociety of CardiologyPeak oxygen uptakeConsecutive patientsHFpEF subgroupsEjection fractionExertional dyspneaPrognostic implications
2017
Exercise Intolerance in Heart Failure With Preserved Ejection Fraction
Houstis N, Eisman A, Pappagianopoulos P, Wooster L, Bailey C, Wagner P, Lewis G. Exercise Intolerance in Heart Failure With Preserved Ejection Fraction. Circulation 2017, 137: 148-161. PMID: 28993402, PMCID: PMC5760316, DOI: 10.1161/circulationaha.117.029058.Peer-Reviewed Original ResearchConceptsCardiopulmonary exercise testingExercise capacityCardiac outputExercise intoleranceHeart failurePathway defectsDiffusing capacityExercise testMechanisms of exercise intolerancePeak VO<sub>2</sub>Patient's cardiac outputSymptoms of HFpEFBody mass indexPatient's exercise capacityEjection fractionHFpEFMass indexInvasive monitoringPatient's defectRelative to controlsBlood gasesMultiple defectsPatientsComorbid defectsDisease heterogeneity
2016
Pulmonary Vascular Distensibility Predicts Pulmonary Hypertension Severity, Exercise Capacity, and Survival in Heart Failure
Malhotra R, Dhakal B, Eisman A, Pappagianopoulos P, Dress A, Weiner R, Baggish A, Semigran M, Lewis G. Pulmonary Vascular Distensibility Predicts Pulmonary Hypertension Severity, Exercise Capacity, and Survival in Heart Failure. Circulation Heart Failure 2016, 9: e003011. PMID: 27301469, PMCID: PMC4911900, DOI: 10.1161/circheartfailure.115.003011.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAntihypertensive AgentsArterial PressureCase-Control StudiesDouble-Blind MethodExercise TestExercise ToleranceFemaleHeart FailureHumansHypertension, PulmonaryKaplan-Meier EstimateLinear ModelsMaleMiddle AgedModels, CardiovascularMultivariate AnalysisPhosphodiesterase 5 InhibitorsPredictive Value of TestsProportional Hazards ModelsProspective StudiesPulmonary ArteryRisk AssessmentRisk FactorsSeverity of Illness IndexSildenafil CitrateStroke VolumeTime FactorsTreatment OutcomeVascular StiffnessVasodilator AgentsVentricular Function, RightConceptsPV distensibilityPulmonary arterial hypertensionReduced ejection fractionHeart failureEjection fractionExercise capacityArterial hypertensionHF patientsRight ventricular ejection fractionPulmonary artery wedge pressureReduced ejection fraction groupPulmonary arterial hypertension groupFirst-pass radionuclide ventriculographyPulmonary vasodilator therapyRV systolic functionVentricular ejection fractionLeft heart failurePulmonary artery pressureEjection fraction groupPulmonary hypertension severityRight ventricular performanceArterial hypertension groupInvasive hemodynamic monitoringWeeks of treatmentPredictors of peak VO2
2015
Pulmonary vascular response patterns during exercise in interstitial lung disease
Degani-Costa L, Levarge B, Digumarthy S, Eisman A, Harris R, Lewis G. Pulmonary vascular response patterns during exercise in interstitial lung disease. European Respiratory Journal 2015, 46: 738-749. PMID: 25976688, DOI: 10.1183/09031936.00191014.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAnaerobic ThresholdCardiac OutputChi-Square DistributionCohort StudiesExercise TestExercise ToleranceFemaleHumansHypertension, PulmonaryLinear ModelsLogistic ModelsLung Diseases, InterstitialMaleMiddle AgedPredictive Value of TestsPrognosisReference ValuesRespiratory Function TestsRetrospective StudiesRisk AssessmentSex FactorsStroke VolumeVascular ResistanceConceptsInterstitial lung diseasePulmonary vascular dysfunctionPulmonary artery pressureAbnormal pulmonary vascular responseInvasive cardiopulmonary exercise testingInterstitial lung disease patientsPulmonary vascular responsePeak oxygen consumptionPulmonary hypertensionAssociated with lower peak oxygen consumptionLung diseaseVascular responsesAbnormal pulmonary artery pressureMean pulmonary artery pressureLow peak oxygen consumptionMinute ventilation/carbon dioxide productionOvert pulmonary hypertensionPulmonary vascular diseaseVentilation/carbon dioxide productionExercise oxygen desaturationPulmonary function testsCardiopulmonary exercise testingBody mass indexMean PAPOxygen desaturation
2014
Mechanisms of Exercise Intolerance in Heart Failure With Preserved Ejection Fraction
Dhakal B, Malhotra R, Murphy R, Pappagianopoulos P, Baggish A, Weiner R, Houstis N, Eisman A, Hough S, Lewis G. Mechanisms of Exercise Intolerance in Heart Failure With Preserved Ejection Fraction. Circulation Heart Failure 2014, 8: 286-294. PMID: 25344549, PMCID: PMC5771713, DOI: 10.1161/circheartfailure.114.001825.Peer-Reviewed Original ResearchConceptsHeart failureExercise capacityEjection fractionC(a-v)O2Peripheral O2 extractionMechanisms of exercise intoleranceElevated systemic blood pressureIV heart failureReduced ejection fractionCardiac filling pressuresInvasive hemodynamic monitoringMaximum incremental cardiopulmonary exercise testingPeripheral microvascular functionPeak respiratory exchange ratioSystemic blood pressureImpaired exercise capacityO2 extractionPredictors of peak VO2Cardiopulmonary exercise testingIncremental cardiopulmonary exercise testImpairing O2 extractionNYHA IIPeak heart ratePeak oxygen uptakeIntrinsic abnormality