{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T22:00:28Z","timestamp":1794088828414,"version":"4.8.0"},"reference-count":96,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":190,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Heart failure (HF) is a multifactorial disease for which peak oxygen uptake (VO2peak) may potentially be a prognostic marker of adverse clinical outcomes. This systematic review and meta-analysis aimed to assess published data on the prognostic impact of VO2peak in HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search of observational studies was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until January 2025. A meta-analysis was conducted using the random-effects inverse-variance model through hazard ratios (HRs). Increased heterogeneity among studies was evaluated through meta-regressions and publication bias via Egger's test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty-four studies were included in this systematic review and meta-analysis. Per 1 mL\/kg\/min increase in VO2peak, all-cause mortality [HR: 0.86, 95% confidence interval (CI) 0.82\u20130.90, I2 = 85%, P &amp;lt; 0.01] and incident ventricular assist device, transplant and all-cause mortality (HR: 0.84, 95% CI 0.79\u20130.89, I2 = 33%, P &amp;lt; 0.01) were significantly reduced, but statistical significance of VO2peak with cardiovascular mortality was not observed (HR: 0.92, 95% CI 0.82\u20131.02, I2 = 0%, P = 0.12) using adjusted models. Variance among studies was detected based on age, sex, body mass index, left ventricular ejection fraction, atrial fibrillation, hypertension, chronic kidney disease, diabetes and treatment. A significant risk of publication bias was evident.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VO2peak is a prognostic marker for multiple causes of mortality and hospitalization in patients with HF, which may promote further insights into patient risk stratification for adverse events and targeted management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.15391","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T09:33:41Z","timestamp":1754991221000},"page":"3624-3642","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Prognostic Impact of Peak Oxygen Consumption in Heart Failure: A Systematic Review and Meta-Analysis"],"prefix":"10.1093","volume":"12","author":[{"given":"Konstantinos","family":"Prokopidis","sequence":"first","affiliation":[{"name":"Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool , Liverpool ,","place":["UK"]},{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , Liverpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9699-1686","authenticated-orcid":false,"given":"Krzysztof","family":"Irlik","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , Liverpool ,","place":["UK"]},{"name":"Students' Scientific Association by the Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia , Katowice ,","place":["Poland"]},{"name":"Doctoral School, Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia , Katowice ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Pia\u015bnik","sequence":"additional","affiliation":[{"name":"Students' Scientific Association by the Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia , Katowice ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuzanna","family":"Michalska","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn , Olsztyn ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirela","family":"Hendel","sequence":"additional","affiliation":[{"name":"Students' Scientific Association by the Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia , Katowice ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Nabrdalik","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , Liverpool ,","place":["UK"]},{"name":"Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia , Katowice ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory 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