{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:13:10Z","timestamp":1786986790353,"version":"build-2736575974"},"reference-count":52,"publisher":"Elsevier BV","issue":"6","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000},"content-version":"am","delay-in-days":370,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/501100002773","name":"Cain Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002773","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart Lung and Blood Institute","doi-asserted-by":"publisher","award":["1P01HL137630"],"award-info":[{"award-number":["1P01HL137630"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["826064"],"award-info":[{"award-number":["826064"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journal.chestnet.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Chest"],"published-print":{"date-parts":[[2022,12]]},"DOI":"10.1016\/j.chest.2022.06.016","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T11:19:51Z","timestamp":1655983191000},"page":"1349-1359","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":17,"title":["Alveolar Dead Space Is Augmented During Exercise in Patients With Heart Failure With Preserved Ejection Fraction"],"prefix":"10.1016","volume":"162","author":[{"given":"Bryce N.","family":"Balmain","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9899-0812","authenticated-orcid":false,"given":"Andrew R.","family":"Tomlinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James P.","family":"MacNamara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4642-7769","authenticated-orcid":false,"given":"Linda S.","family":"Hynan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin D.","family":"Levine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satyam","family":"Sarma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0515-2164","authenticated-orcid":false,"given":"Tony G.","family":"Babb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"4","key":"10.1016\/j.chest.2022.06.016_bib1","first-page":"e38","article-title":"Heart disease and stroke statistics\u20142016 update: a report from the American Heart Association","volume":"133","author":"Mozaffarian","year":"2016","journal-title":"Circulation"},{"issue":"1","key":"10.1016\/j.chest.2022.06.016_bib2","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1161\/CIRCULATIONAHA.116.021884","article-title":"Phenotype-specific treatment of heart failure with preserved ejection fraction: a multiorgan roadmap","volume":"134","author":"Shah","year":"2016","journal-title":"Circulation"},{"issue":"5","key":"10.1016\/j.chest.2022.06.016_bib3","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1161\/CIRCHEARTFAILURE.109.930701","article-title":"Exercise hemodynamics enhance diagnosis of early heart failure with preserved ejection fraction","volume":"3","author":"Borlaug","year":"2010","journal-title":"Circ Heart Fail"},{"issue":"44","key":"10.1016\/j.chest.2022.06.016_bib4","doi-asserted-by":"crossref","first-page":"3103","DOI":"10.1093\/eurheartj\/ehu315","article-title":"Pulmonary capillary wedge pressure during exercise and long-term mortality\u00a0in patients with suspected heart failure\u00a0with preserved ejection fraction","volume":"35","author":"Dorfs","year":"2014","journal-title":"Eur Heart J"},{"issue":"5","key":"10.1016\/j.chest.2022.06.016_bib5","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.117.004750","article-title":"Pulmonary capillary wedge pressure patterns during exercise predict exercise capacity and incident heart failure","volume":"11","author":"Eisman","year":"2018","journal-title":"Circ Heart Fail"},{"issue":"5","key":"10.1016\/j.chest.2022.06.016_bib6","doi-asserted-by":"crossref","first-page":"R602","DOI":"10.1152\/ajpregu.00192.2020","article-title":"Effects of exercise on thoracic blood volumes, lung fluid accumulation, and pulmonary diffusing capacity in heart failure with preserved ejection fraction","volume":"319","author":"Fermoyle","year":"2020","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"key":"10.1016\/j.chest.2022.06.016_bib7","doi-asserted-by":"crossref","first-page":"3721","DOI":"10.1093\/eurheartj\/ehz713","article-title":"The haemodynamic basis of lung congestion during exercise in heart failure with preserved ejection fraction","volume":"40","author":"Reddy","year":"2019","journal-title":"Eur Heart J"},{"issue":"17","key":"10.1016\/j.chest.2022.06.016_bib8","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1161\/CIRCULATIONAHA.117.031608","article-title":"Global pulmonary vascular remodeling in pulmonary hypertension associated with heart failure and preserved or reduced ejection fraction","volume":"137","author":"Fayyaz","year":"2018","journal-title":"Circulation"},{"issue":"6","key":"10.1016\/j.chest.2022.06.016_bib9","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.jchf.2016.03.001","article-title":"Impaired pulmonary diffusion in heart failure with preserved ejection fraction","volume":"4","author":"Olson","year":"2016","journal-title":"JACC Heart Fail"},{"issue":"13","key":"10.1016\/j.chest.2022.06.016_bib10","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/j.jacc.2009.01.006","article-title":"The role of the pulmonary vasculature in heart failure with preserved ejection fraction","volume":"53","author":"Lewis","year":"2009","journal-title":"J\u00a0Am Coll Cardiol"},{"issue":"43","key":"10.1016\/j.chest.2022.06.016_bib11","doi-asserted-by":"crossref","first-page":"3293","DOI":"10.1093\/eurheartj\/ehw241","article-title":"Abnormal right ventricular-pulmonary artery coupling with exercise in heart failure with preserved ejection fraction","volume":"37","author":"Borlaug","year":"2016","journal-title":"Eur Heart J"},{"issue":"10 pt B","key":"10.1016\/j.chest.2022.06.016_bib12","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/j.jcmg.2016.12.024","article-title":"RV contractile function and its coupling to pulmonary circulation in heart failure with preserved ejection fraction: stratification of clinical phenotypes and outcomes","volume":"10","author":"Guazzi","year":"2017","journal-title":"JACC Cardiovasc Imaging"},{"issue":"48","key":"10.1016\/j.chest.2022.06.016_bib13","doi-asserted-by":"crossref","first-page":"3452","DOI":"10.1093\/eurheartj\/ehu193","article-title":"Right heart dysfunction in heart failure with preserved ejection fraction","volume":"35","author":"Melenovsky","year":"2014","journal-title":"Eur Heart J"},{"issue":"3","key":"10.1016\/j.chest.2022.06.016_bib14","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1161\/CIRCHEARTFAILURE.114.002114","article-title":"Enhanced pulmonary vasodilator reserve and abnormal right ventricular: pulmonary artery coupling in heart failure with preserved ejection fraction","volume":"8","author":"Andersen","year":"2015","journal-title":"Circ Heart Fail"},{"issue":"7","key":"10.1016\/j.chest.2022.06.016_bib15","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1002\/ejhf.664","article-title":"Different correlates but similar prognostic implications for right ventricular dysfunction in heart failure patients with reduced or preserved ejection fraction","volume":"19","author":"Ghio","year":"2017","journal-title":"Eur J Heart Fail"},{"issue":"17","key":"10.1016\/j.chest.2022.06.016_bib16","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.1016\/j.jacc.2019.01.072","article-title":"Exercise intolerance in patients with heart failure: JACC state-of-the-art review","volume":"73","author":"Del Buono","year":"2019","journal-title":"J\u00a0Am Coll Cardiol"},{"issue":"5","key":"10.1016\/j.chest.2022.06.016_bib17","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1378\/chest.106.5.1476","article-title":"Inaccuracy of noninvasive estimates of VD\/VT in clinical exercise testing","volume":"106","author":"Lewis","year":"1994","journal-title":"Chest"},{"issue":"30","key":"10.1016\/j.chest.2022.06.016_bib18","doi-asserted-by":"crossref","first-page":"2810","DOI":"10.1093\/eurheartj\/ehy268","article-title":"Haemodynamics, dyspnoea, and pulmonary reserve in heart failure with preserved ejection fraction","volume":"39","author":"Obokata","year":"2018","journal-title":"Eur Heart J"},{"issue":"12","key":"10.1016\/j.chest.2022.06.016_bib19","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1002\/ejhf.913","article-title":"Physiological dead space and arterial carbon dioxide contributions to exercise ventilatory inefficiency in patients with reduced or preserved ejection fraction heart failure","volume":"19","author":"Van Iterson","year":"2017","journal-title":"Eur J Heart Fail"},{"issue":"16","key":"10.1016\/j.chest.2022.06.016_bib20","article-title":"Simultaneous measurement of lung diffusing capacity and pulmonary hemodynamics reveals exertional alveolar-capillary dysfunction in heart failure with preserved ejection fraction","volume":"10","author":"Fermoyle","year":"2021","journal-title":"J\u00a0Am Heart Assoc"},{"issue":"1","key":"10.1016\/j.chest.2022.06.016_bib21","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1152\/japplphysiol.00474.2021","article-title":"Estimating exercise Paco2 in patients with heart failure with preserved ejection fraction","volume":"132","author":"Balmain","year":"2022","journal-title":"J\u00a0Appl Physiol (1985)"},{"key":"10.1016\/j.chest.2022.06.016_bib22","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1152\/japplphysiol.00786.2021","article-title":"Physiological dead space during exercise in patients with heart failure with preserved ejection fraction","volume":"132","author":"Balmain","year":"2022","journal-title":"J\u00a0Appl Physiol"},{"issue":"1","key":"10.1016\/j.chest.2022.06.016_bib23","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1183\/09031936.00039214","article-title":"The physiological basis of pulmonary gas exchange: implications for clinical interpretation of arterial blood gases","volume":"45","author":"Wagner","year":"2015","journal-title":"Eur Respir J"},{"key":"10.1016\/j.chest.2022.06.016_bib24","series-title":"Morphometry of the Human Lung","author":"Weibel","year":"1963"},{"issue":"3","key":"10.1016\/j.chest.2022.06.016_bib25","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1152\/jappl.1957.10.3.335","article-title":"Alveolar dead space as an index of distribution of blood flow in pulmonary capillaries","volume":"10","author":"Severinghaus","year":"1957","journal-title":"J\u00a0Appl Physiol"},{"issue":"1","key":"10.1016\/j.chest.2022.06.016_bib26","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1152\/japplphysiol.00113.2019","article-title":"The interactions between respiratory and cardiovascular systems in systolic heart failure","volume":"128","author":"Cross","year":"2019","journal-title":"J\u00a0Appl Physiol"},{"issue":"1","key":"10.1016\/j.chest.2022.06.016_bib27","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1249\/JES.0000000000000208","article-title":"Exercise intolerance in heart failure: central role for the pulmonary system","volume":"48","author":"Lalande","year":"2019","journal-title":"Exerc Sport Sci Rev"},{"issue":"3","key":"10.1016\/j.chest.2022.06.016_bib28","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1152\/jappl.1997.82.3.746","article-title":"Ventilatory response to exercise in subjects breathing CO2 or HeO2","volume":"82","author":"Babb","year":"1997","journal-title":"J\u00a0Appl Physiol"},{"issue":"4","key":"10.1016\/j.chest.2022.06.016_bib29","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1002\/ehf2.12458","article-title":"Prognostic impact of Framingham heart failure criteria in heart failure with preserved ejection fraction","volume":"6","author":"Lofstrom","year":"2019","journal-title":"ESC Heart Fail"},{"issue":"2","key":"10.1016\/j.chest.2022.06.016_bib30","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1183\/09031936.05.00034805","article-title":"Standardisation of spirometry","volume":"26","author":"Miller","year":"2005","journal-title":"Eur Respir J"},{"key":"10.1016\/j.chest.2022.06.016_bib31","doi-asserted-by":"crossref","DOI":"10.1016\/j.resp.2020.103472","article-title":"External dead space explains sex-differences in the ventilatory response to submaximal exercise in children with and without obesity","volume":"279","author":"Balmain","year":"2020","journal-title":"Respir Physiol Neurobiol"},{"issue":"1","key":"10.1016\/j.chest.2022.06.016_bib32","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1152\/japplphysiol.00820.2007","article-title":"Short-term modulation of the exercise ventilatory response in young men","volume":"104","author":"Wood","year":"2008","journal-title":"J\u00a0Appl Physiol (1985)"},{"key":"10.1016\/j.chest.2022.06.016_bib33","series-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen","year":"1977"},{"key":"10.1016\/j.chest.2022.06.016_bib34","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1378\/chest.106.1.131","article-title":"Estimated vs\u00a0actual values for dead space\/tidal volume ratios during incremental exercise in patients evaluated for dyspnea","volume":"106","author":"Zimmerman","year":"1994","journal-title":"Chest"},{"key":"10.1016\/j.chest.2022.06.016_bib35","series-title":"Principles of Exercise Testing and Interpreation","author":"Wasserman","year":"2005"},{"issue":"3","key":"10.1016\/j.chest.2022.06.016_bib36","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1161\/01.CIR.77.3.552","article-title":"Increased exercise ventilation in patients with chronic heart failure: intact ventilatory control despite hemodynamic and pulmonary abnormalities","volume":"77","author":"Sullivan","year":"1988","journal-title":"Circulation"},{"key":"10.1016\/j.chest.2022.06.016_bib37","doi-asserted-by":"crossref","first-page":"659","DOI":"10.3389\/fphys.2020.00659","article-title":"Measurement and interpretation of exercise ventilatory efficiency","volume":"11","author":"Phillips","year":"2020","journal-title":"Front Physiol"},{"issue":"6","key":"10.1016\/j.chest.2022.06.016_bib38","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1378\/chest.109.6.1566","article-title":"Pathophysiology of activity limitation in patients with interstitial lung disease","volume":"109","author":"Hansen","year":"1996","journal-title":"Chest"},{"key":"10.1016\/j.chest.2022.06.016_bib39","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1183\/09031936.00135514","article-title":"Exercise ventilatory inefficiency in mild to end-stage COPD","volume":"45","author":"Neder","year":"2015","journal-title":"Eur Respir J"},{"issue":"2","key":"10.1016\/j.chest.2022.06.016_bib40","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.ccm.2019.02.010","article-title":"Pulmonary limitations in heart failure","volume":"40","author":"Cundrle","year":"2019","journal-title":"Clin Chest Med"},{"issue":"11","key":"10.1016\/j.chest.2022.06.016_bib41","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1164\/rccm.201508-1555OC","article-title":"Increased dead space ventilation mediates reduced exercise capacity in systolic heart failure","volume":"193","author":"Kee","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.chest.2022.06.016_bib42","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/S1388-9842(99)00060-4","article-title":"Ventilatory capacity and exercise tolerance in patients with chronic stable heart failure","volume":"2","author":"Clark","year":"2000","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.chest.2022.06.016_bib43","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1136\/hrt.77.2.138","article-title":"The increased ventilatory response to exercise in chronic heart failure: relation to pulmonary pathology","volume":"77","author":"Clark","year":"1997","journal-title":"Heart"},{"issue":"5 suppl","key":"10.1016\/j.chest.2022.06.016_bib44","doi-asserted-by":"crossref","first-page":"192S","DOI":"10.1378\/chest.101.5_Supplement.192S","article-title":"Ventilation-perfusion matching during exercise","volume":"101","author":"Wagner","year":"1992","journal-title":"Chest"},{"issue":"4","key":"10.1016\/j.chest.2022.06.016_bib45","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1183\/09031936.00037014","article-title":"Gas exchange and ventilation-perfusion relationships in the lung","volume":"44","author":"Petersson","year":"2014","journal-title":"Eur Respir J"},{"key":"10.1016\/j.chest.2022.06.016_bib46","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1183\/09031936.00137614","article-title":"Dead space: the physiology of wasted ventilation","volume":"45","author":"Robertson","year":"2015","journal-title":"Eur Respir J"},{"key":"10.1016\/j.chest.2022.06.016_bib47","series-title":"The Multiple Inert Gas Elimination Technique (MIGET)","author":"Hopkins","year":"2017"},{"issue":"6","key":"10.1016\/j.chest.2022.06.016_bib48","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.1152\/jappl.1999.87.6.1997","article-title":"Exercise-induced arterial hypoxemia","volume":"87","author":"Dempsey","year":"1999","journal-title":"J\u00a0Appl Phsyiol"},{"issue":"2","key":"10.1016\/j.chest.2022.06.016_bib49","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1113\/expphysiol.2006.034371","article-title":"Ventilatory control in humans: constraints and limitations","volume":"92","author":"Ward","year":"2007","journal-title":"Exp Physiol"},{"issue":"7","key":"10.1016\/j.chest.2022.06.016_bib50","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1513\/AnnalsATS.202006-746OC","article-title":"Obesity blunts the ventilatory response to exercise in men and women","volume":"18","author":"Balmain","year":"2021","journal-title":"Ann Am Thorac Soc"},{"key":"10.1016\/j.chest.2022.06.016_bib51","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1378\/chest.117.2.321","article-title":"Ventilatory constraints during exercise in patients with chronic heart failure","volume":"117","author":"Johnson","year":"2000","journal-title":"Chest"},{"issue":"3","key":"10.1016\/j.chest.2022.06.016_bib52","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1152\/jappl.1980.49.3.528","article-title":"Relation between respiratory valve dead space and tidal volume","volume":"49","author":"Bradley","year":"1980","journal-title":"J\u00a0Appl Physiol"}],"container-title":["Chest"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0012369222011825?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0012369222011825?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T04:00:33Z","timestamp":1778644833000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0012369222011825"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":52,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["S0012369222011825"],"URL":"https:\/\/doi.org\/10.1016\/j.chest.2022.06.016","relation":{},"ISSN":["0012-3692"],"issn-type":[{"value":"0012-3692","type":"print"}],"subject":[],"published":{"date-parts":[[2022,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Alveolar Dead Space Is Augmented During Exercise in Patients With Heart Failure With Preserved Ejection Fraction","name":"articletitle","label":"Article Title"},{"value":"Chest","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.chest.2022.06.016","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}