{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:49:46Z","timestamp":1791823786414,"version":"4.3.4"},"reference-count":140,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":1228,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2022,7,31]],"date-time":"2022-07-31T00:00:00Z","timestamp":1659225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Patients with heart failure with preserved ejection fraction (HFpEF) universally complain of exercise intolerance and dyspnoea as key clinical correlates. Cardiac as well as extracardiac components play a role for the limited exercise capacity, including an impaired cardiac and peripheral vascular reserve, a limitation in mechanical ventilation and\/or gas exchange with reduced pulmonary vascular reserve, skeletal muscle dysfunction and iron deficiency\/anaemia. Although most of these components can be differentiated and quantified through gas exchange analysis by cardiopulmonary exercise testing (CPET), the information provided by objective measures of exercise performance has not been systematically considered in the recent algorithms\/scores for HFpEF diagnosis, by neither European nor US groups. The current clinical consensus statement by the Heart Failure Association (HFA) and European Association of Preventive Cardiology (EAPC) of the European Society of Cardiology (ESC) aims at outlining the role of exercise testing and its pathophysiological, clinical and prognostic insights, addressing the implications of a thorough functional evaluation from the diagnostic algorithm to the pathophysiology and treatment perspectives of HFpEF. Along with these goals, we provide a specific analysis of the evidence that CPET is the standard for assessing, quantifying, and differentiating the origin of dyspnoea and exercise impairment and even more so when combined with echocardiography and\/or invasive haemodynamic evaluation. This will lead to improved quality of diagnosis when applying the proposed scores and may also help to implement the progressive characterization of the specific HFpEF phenotypes, a critical step toward the delivery of phenotype-specific treatments.<\/jats:p>","DOI":"10.1002\/ejhf.2601","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T04:38:45Z","timestamp":1656650325000},"page":"1327-1345","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":144,"title":["Exercise Testing in Heart Failure with Preserved Ejection Fraction: An Appraisal Through Diagnosis, Pathophysiology and Therapy \u2013 A Clinical Consensus Statement of the Heart Failure Association and European Association of Preventive Cardiology of the European Society of Cardiology"],"prefix":"10.1093","volume":"24","author":[{"given":"Marco","family":"Guazzi","sequence":"first","affiliation":[{"name":"Division of Cardiology, University of Milano School of Medicine, San Paolo Hospital , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Wilhelm","sequence":"additional","affiliation":[{"name":"Department of Cardiology Inselspital, Bern University Hospital, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Halle","sequence":"additional","affiliation":[{"name":"Department of Prevention and Sports Medicine, Faculty of Medicine, University Hospital \u2018Klinikum rechts der Isar\u2019, Technical University Munich , Munich ,","place":["Germany"]},{"name":"DZHK (Deutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung), partner site Munich, Munich Heart Alliance , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emeline","family":"Van Craenenbroeck","sequence":"additional","affiliation":[{"name":"Research Group Cardiovascular Diseases, GENCOR, University of Antwerp , Antwerp ,","place":["Belgium"]},{"name":"Department of Cardiology, Antwerp University Hospital , Edegem ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hareld","family":"Kemps","sequence":"additional","affiliation":[{"name":"Department of Cardiology, M\u00e1xima Medical Center , Eindhoven ,","place":["The Netherlands"]},{"name":"Department of Industrial Design, Eindhoven University of Technology , Eindhoven ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolph A.","family":"de Boer","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, Department of Cardiology, University of Groningen , Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.S.","family":"Coats","sequence":"additional","affiliation":[{"name":"Warwick Medical School, University of Warwick , Coventry ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Lund","sequence":"additional","affiliation":[{"name":"Solna, Solna, Karolinska Institutet , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Mancini","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Icahn School of Medicine at Mount Sinai , New York, NY ,","place":["USA"]},{"name":"Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Borlaug","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"National and Kapodistrian 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