{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:49:42Z","timestamp":1792183782293,"version":"4.4.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":50,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"UTMB Institute for Translational Sciences"},{"name":"Clinical and Translational Science Award","award":["UM1 TR005443"],"award-info":[{"award-number":["UM1 TR005443"]}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institutes of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Cardiopulmonary exercise testing (CPET) carries a Class I recommendation for advanced heart failure (HF) therapy candidacy. Whether CPET utilization and outcomes differ by race is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using TriNetX, adults with HF (ICD-10 I50.x, 2010\u201323) were stratified by race\/ethnicity and CPET receipt (CPT 94621) within 1 year of diagnosis. All-cause mortality and HF hospitalization were assessed at 1, 3, and 5 years after 1:1 propensity score matching for demographics, HF subtype, comorbidities, and guideline-directed medical therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 807 379 patients with HF (mean age 69.2 years, 46.2% female), 10 268 (1.27%) underwent CPET within 1 year. Utilization was 1.39% in White, 1.20% in Black, 0.69% in Hispanic, and 0.79% in Asian patients. After matching, 8355 pairs were analysed. CPET was associated with lower 1-year mortality in White (hazard ratio [HR] 0.58, 95% CI 0.51\u20130.65, P &amp;lt; .001) and Hispanic (HR 0.50, 0.25\u20130.98, P = .040) patients. Asian patients reached borderline significance at 5 years (HR 0.54, 0.29\u20131.00, P = .048). Black patients showed a non-significant trend (1-year HR 0.70, 0.39\u20131.24, P = .214). HF hospitalization was higher in White (1-year HR 1.18, 1.14\u20131.23, P &amp;lt; .001) and Asian (HR 1.73, 1.35\u20132.21, P &amp;lt; .001) CPET recipients, suggesting surveillance bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CPET utilization was associated with lower mortality in White and Hispanic patients, with borderline significance in Asian patients at 5 years and a non-significant trend in Black patients. These associations may reflect engagement with speciality HF care rather than testing itself. Minority patients were under-represented among CPET recipients, highlighting CPET access as a marker of inequity in advanced HF care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag231","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:48:24Z","timestamp":1791546504000},"source":"Crossref","is-referenced-by-count":0,"title":["Cardiopulmonary exercise testing utilization and clinical outcomes among patients with heart failure across racial and ethnic groups"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3473-0880","authenticated-orcid":false,"given":"James","family":"Rice","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Texas Medical Branch , 301 University Blvd, Galveston, TX 77555 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