{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:09:50Z","timestamp":1753870190254,"version":"3.41.2"},"reference-count":5,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"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":["Respirology Case Reports"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A 60\u2010year\u2010old delivery man was referred for evaluation of unexplained exertional dyspnoea despite initial non\u2010diagnostic investigations, including pulmonary function tests and dobutamine stress echocardiography. A symptom\u2010limited cardiopulmonary exercise test (CPET) revealed chronotropic incompetence (CI), reduced oxygen uptake (VO<jats:sub>2<\/jats:sub>)\/work slope at moderate\u2013high workload, and ST\u2010segment depression on recovery electrocardiogram. Coronary angiogram confirmed severe stenosis in right coronary artery and left anterior descending artery, for which he underwent percutaneous coronary stenting and cardiac rehabilitation. An interval CPET showed improvement in heart rate (HR) response and aerobic capacity. CI is characterized by an attenuated HR response to incremental exercise or an increased HR reserve despite maximal effort. Clinically, it is an independent predictor of adverse cardiovascular events and mortality. CI is frequently overlooked, highlighting the importance of CPET in the diagnostic workup of unexplained dyspnoea.<\/jats:p>","DOI":"10.1002\/rcr2.807","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T08:49:28Z","timestamp":1624956568000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exercise intolerance due to chronotropic incompetence uncovered by cardiopulmonary exercise test: an often overlooked manifestation of ischaemic heart disease"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0607-9579","authenticated-orcid":false,"given":"Sharlene","family":"Ho","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Tan Tock Seng Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danqing","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Tan Tock Seng Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2566-9854","authenticated-orcid":false,"given":"Geak Poh","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Tan Tock Seng Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.167.2.211"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.940577"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.11.045"},{"volume-title":"Principles of exercise testing and interpretation: including pathophysiology and clinical applications","year":"2012","author":"Wasserman K","key":"e_1_2_4_5_1"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00376-8"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.807","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/rcr2.807","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.807","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:19:34Z","timestamp":1693354774000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.807"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,29]]},"references-count":5,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1002\/rcr2.807"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.807","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"type":"print","value":"2051-3380"},{"type":"electronic","value":"2051-3380"}],"subject":[],"published":{"date-parts":[[2021,6,29]]},"assertion":[{"value":"2021-05-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00807"}}