{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:53:09Z","timestamp":1791384789505,"version":"4.3.3"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":41,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"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<\/jats:title>\n                    <jats:p>Baseline intracavitary haemodynamic measurements frequently demonstrate an inconsistent relationship with exertional performance. This may reflect an incomplete interpretation of left ventricular (LV) filling pressures. LV transmural pressure difference (\u0394PTM = LV end-diastolic pressure [LVEDP]\u2014right atrial pressure [RAP]) integrates LV filling pressure with right ventricular\/pericardial constraint and may provide a composite representation of resting haemodynamic conditions. Ventilatory efficiency, assessed by the minute ventilation-carbon dioxide production (VE\/VCO2) slope during cardiopulmonary exercise testing (CPET), is a leading representation of cardiopulmonary reserves and a powerful prognostic marker in heart failure (HF). Whether \u0394PTM is associated with exercise ventilatory efficiency beyond conventional resting filling pressure measurements remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied 422 patients with advanced HF (LVEF \u226425%) who underwent right-heart catheterization and CPET. \u0394PTM was analysed both continuously and by tertiles. The primary outcome was VE\/VCO2 slope; peak VO2 was a secondary outcome. Bayesian multivariable regression models were adjusted using a directed acyclic graph-derived confounder set. Sensitivity analyses compared \u0394PTM with LVEDP and RAP modelled individually and jointly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 422 patients (mean age 51.3 \u00b1 10.8 years; 62 [14.7%] female), higher \u0394PTM was independently associated with a lower VE\/VCO2 slope (posterior mean \u03b2 = \u22120.34 per mmHg; 95% credible interval [CrI] \u22120.58 to \u22120.11; 99.7% posterior probability of a negative association). Unadjusted VE\/VCO2 slope decreased from 40.2 (31.7\u201367.1) in the lowest \u0394PTM tertile to 34.9 (30.6\u201344.8) in the highest tertile (P = .029). The adjusted posterior predictive difference between the highest and lowest \u0394PTM tertiles was \u22124.42 units (95% CrI \u22127.85 to \u22120.62). Following multivariable adjustment, \u0394PTM showed no significant association with peak VO2 (posterior mean \u03b2 = +0.06; 95% CrI \u22120.02 to +0.14). Neither LVEDP nor RAP, modelled individually or jointly, demonstrated independent associations with ventilatory efficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Resting \u0394PTM was inversely associated with the VE\/VCO2 slope during exercise, whereas no independent association was observed with peak VO2. Compared with individual left- or right-sided filling pressures, \u0394PTM provides a parsimonious summary of the balance between left-sided distending pressure and right-sided constraint associated with ventilatory efficiency in advanced HF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag247","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:34:37Z","timestamp":1791286477000},"source":"Crossref","is-referenced-by-count":0,"title":["Left ventricular transmural pressure and ventilatory inefficiency during exercise in advanced heart failure"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1424-2209","authenticated-orcid":false,"given":"Barkin","family":"Kultursay","sequence":"first","affiliation":[{"name":"Department of Cardiology, Tunceli State Hospital , Cumhuriyet Mah. 552. Sokak No: 2, 62000 Tunceli\/Merkez ,","place":["T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seda","family":"Tanyeri Uzel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital , Istanbul ,","place":["Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Karacam","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bitlis State Hospital , Bitlis ,","place":["Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seref Berk","family":"Tuncer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital , Istanbul ,","place":["Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azmican","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital , Istanbul ,","place":["Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halit","family":"Eminoglu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital , Istanbul ,","place":["Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suleyman Cagan","family":"Efe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital , Istanbul ,","place":["Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulumser Sevgin","family":"Halil","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital , Istanbul ,","place":["Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cem","family":"Dogan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital , Istanbul ,","place":["Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4432-4595","authenticated-orcid":false,"given":"Deniz","family":"Mutlu","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology, Mount Sinai Hospital , New York City, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Kaan","family":"Kirali","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kartal Kosuyolu High Specialization Education and Research Hospital , Istanbul ,","place":["Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rezzan Deniz","family":"Acar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital , Istanbul ,","place":["Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Aslanger","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Basaksehir Pine and Sakura City Hospital , Istanbul ,","place":["Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"2026100710034709700_xvag247-B1","doi-asserted-by":"publisher","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 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