{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:16:51Z","timestamp":1787509011103,"version":"build-2736575974"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"vor","delay-in-days":163,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The diagnosis of heart failure with preserved ejection fraction (HFpEF) remains challenging based on resting assessments. Exercise echocardiography is often used to unmask abnormalities that develop during exercise, but the diagnostic criteria have not been standardized. This study aimed to elucidate how cardiologists utilize exercise echocardiography to diagnose HFpEF in real-world practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>An international web-based survey involving 87 cardiologists was performed. We also performed a retrospective cross-sectional study to investigate the impact of different exercise echocardiographic diagnostic criteria in 652 dyspnoeic patients who underwent exercise echocardiography. The HFA-PEFF algorithm was the most commonly used exercise echocardiography criterion for HFpEF diagnoses (48%), followed by the ASE\/EACVI criteria (24%) and other combinations of multiple parameters (22%). Among 652 patients, the proportion of HFpEF diagnosis varied substantially according to the criteria used ranging from 20.1% (ASE\/EACVI criteria) to 44.3% (HFA-PEFF algorithm). Many cases (49.4\u201370.5%) remained indeterminate after exercise echocardiography, but only 41% of surveyed cardiologists would utilize exercise right heart catheterization to resolve an indeterminate result. Despite these diagnostic uncertainties, 54% of surveyed cardiologists would utilize exercise echocardiography results to initiate sodium\u2013glucose co-transporter 2 inhibitors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In real-world practice, exercise echocardiographic criteria utilized across cardiologists vary, which meaningfully impacts the frequency of HFpEF diagnoses, with indeterminate results being common. Despite these diagnostic uncertainties, many cardiologists initiate pharmacotherapy based on exercise echocardiography. The lack of consensus on universal diagnostic criteria for exercise echocardiography and approaches to indeterminate results may limit the delivery of evidence-based treatment for HFpEF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjimp\/qyae059","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T07:27:05Z","timestamp":1718090825000},"source":"Crossref","is-referenced-by-count":7,"title":["Variability in approach to exercise stress echocardiography for diagnosis of heart failure with preserved ejection fraction: an international survey on real-world practice"],"prefix":"10.1093","volume":"2","author":[{"given":"Yuta","family":"Tani","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine , 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogesh N V","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Mayo Clinic , Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik H","family":"Verbrugge","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Diseases, University Hospital Brussels , Jette 1090 , Belgium"},{"name":"Faculty of Medicine and Pharmacy, Vrije Universiteit Brussels , Jette 1090 , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9067-4129","authenticated-orcid":false,"given":"Jeong Hoon","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul 06351 , Republic of Korea"},{"name":"Department of Cardiology, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul 06351 , Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuaki","family":"Negishi","sequence":"additional","affiliation":[{"name":"Nepean Clinical School, Faculty of Medicine and Health, University of Sydney , Sydney, New South Wales 2747 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomonari","family":"Harada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine , 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Kagami","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine , 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 , Japan"},{"name":"Division of Cardiovascular Medicine, National Defense Medical College , Tokorozawa, Saitama 359-8513 , 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