Heart failure & cardiomyopathies
Cardiopulmonary exercise testing utilization and clinical outcomes among patients with heart failure across racial and ethnic groups
Authors' conclusion
CPET utilization was associated with lower mortality in White and Hispanic patients, with borderline significance in Asian patients at 5 years and a non-significant trend in Black patients. These associations may reflect engagement with speciality HF care rather than testing itself. Minority patients were under-represented among CPET recipients, highlighting CPET access as a marker of inequity in advanced HF care.
Study context
- Population
- Adults with heart failure (HF) (ICD-10 I50.x, 2010–23), stratified by race/ethnicity and cardiopulmonary exercise testing (CPET) receipt (CPT 94,621) within 1 year of diagnosispatients with HF, after matching, 8355 pairs were analysed
- Participants
- 807,379 adults
- Comparison
- CPET receipt within 1 year of diagnosis, by race/ethnicity, after 1:1 propensity score matching
- CPET recipientsn = 10,268
Methodological detailsTriNetX
- TriNetX
Main finding
As reported in the abstract
CPET utilization · within 1 year
- Overall
- 1.27%
- White
- 1.39%
- Black
- 1.20%
- Hispanic
- 0.69%
- Asian
- 0.79%
Further findings
All-cause mortality
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| CPET recipients · White, 1-year · after matching | 0.58 (0.51–0.65) | P < 0.001 | |
| CPET recipients · Hispanic, 1-year · after matching | 0.50 (0.25–0.98) | P = 0.040 | |
| CPET recipients · Asian, 5 years; borderline significance · after matching | 0.54 (0.29–1.00) | P = 0.048 | |
| CPET recipients · Black, 1-year; non-significant trend · after matching | 0.70 (0.39–1.24) | P = 0.214 | |
| 0.20.5125Hazard ratio (log scale) |
HF hospitalization
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| CPET recipients · White, 1-year; higher · suggesting surveillance bias | 1.18 (1.14–1.23) | P < 0.001 | |
| CPET recipients · Asian; higher · suggesting surveillance bias | 1.73 (1.35–2.21) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Original publication
Cardiopulmonary exercise testing utilization and clinical outcomes among patients with heart failure across racial and ethnic groups. ESC Heart Fail. Published 16 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it