Heart failure & cardiomyopathiesResearch article
Left ventricular transmural pressure and ventilatory inefficiency during exercise in advanced heart failure
- retrospectively studied
- Bayesian multivariable regression models
- directed acyclic graph-derived confounder set
Authors' conclusion
Resting ΔPTM was inversely associated with the VE/VCO2 slope during exercise, whereas no independent association was observed with peak VO2. Compared with individual left- or right-sided filling pressures, ΔPTM provides a parsimonious summary of the balance between left-sided distending pressure and right-sided constraint associated with ventilatory efficiency in advanced HF.
Study context
- Population
- Patients with advanced heart failure (HF) (LVEF ≤25%) who underwent right-heart catheterization and cardiopulmonary exercise testing (CPET)patients with advanced HF
- Participants
- 422 patients
- Comparison
- ΔPTM analysed both continuously and by tertiles
- Outcome
- VE/VCO2 slope
Main finding
As reported in the abstract
lowest ΔPTM tertile
40.2
unadjusted · range as printed 31.7–67.1
highest ΔPTM tertile
34.9
unadjusted · range as printed 30.6–44.8
Adjusted posterior predictive difference, units (95% CI)
highest ΔPTM tertile vs lowest ΔPTM tertile
−4.42(−7.85 to −0.62)
- ΔPTM · higher ΔPTM associated with lower VE/VCO2 slope; 99.7% posterior probability of a negative association
- posterior mean β −0.34 per mmHg (95% CI −0.58 to −0.11)
Secondary outcomes
| Outcome | posterior mean β (95% CI) |
|---|---|
| peak VO2 · no significant association · secondary outcome · Following multivariable adjustment | +0.06 (−0.02 to +0.14) |
Ventilatory efficiency, LVEDP and RAP (sensitivity analyses)
- Neither LVEDP nor RAP, modelled individually or jointly, demonstrated independent associations with ventilatory efficiency
Original publication
Left ventricular transmural pressure and ventilatory inefficiency during exercise in advanced heart failure. ESC Heart Fail. Published 7 October 2026. doi:10.1093/eschf/xvag247
Summarised from the published abstract; every number is checked against it