{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:12:56Z","timestamp":1792005176240,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Exaggerated blood pressure response (ExBPR) to exercise, often defined as peak systolic blood pressure (SBP)\u00a0\u2265\u00a0210\u00a0mm Hg in men and \u2265190\u00a0mm\u00a0Hg in women, has limited clinical utility due to inconsistent prognostic data. Workload\u2010indexed SBP, expressed as SBP\/metabolic equivalent of task (MET) slope, has emerged as a potentially superior marker of cardiovascular risk. This study aims to evaluate the association of exercise SBP parameters with left ventricular (LV) remodeling and function, and to unveil which exercise SBP marker more accurately reflects adverse cardiac remodeling and function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied 455 individuals who underwent echocardiography and treadmill testing within 1\u00a0day at a single center in Korea. Echocardiographic parameters included left ventricular (LV) end\u2010diastolic dimension (EDD), relative wall thickness (RWT) and e\u2032 velocity. SBP\/MET slope was calculated as (peak\u2014resting SBP)\/(maximal METs\u22121).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants with SBP\/Met slope &gt;6.2\u00a0mm Hg\/MET were older, had higher body mass index, and exhibited smaller LV EDD index, higher RWT, and lower e\u2032 velocity (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). They also showed higher resting and peak SBP and lower exercise capacity. ExBPR was associated with similar structural and functional abnormalities but not with exercise capacity. In individuals without ExBPR, higher SBP\/MET slope identified smaller LV EDD index, higher RWT, and lower e\u2032 velocity (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). Multivariable analyses confirmed independent associations of SBP\/MET slope with concentric LV structure represented by high RWT and lower e\u2032 velocity, beyond resting SBP. Adding SBP\/MET slope to ExBPR improved prediction of reduced e\u2032 velocity (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.021).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SBP\/MET slope was independently associated with concentric LV structure and diastolic dysfunction, providing incremental clinical value over ExBPR in detecting subclinical cardiac abnormalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70380","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T05:31:18Z","timestamp":1766986278000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Incremental Value of Workload\u2010Indexed Blood Pressure Response Over Exaggerated Blood Pressure Response to Exercise in Detecting Adverse Left Ventricular Remodeling and Function"],"prefix":"10.1111","volume":"42","author":[{"given":"In\u2010Jeong","family":"Cho","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Ewha Womans University Seoul Hospital Ewha Womans University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang\u2010Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Ewha Womans University Seoul Hospital Ewha Womans University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wook Bum","family":"Pyun","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Ewha Womans University Seoul Hospital Ewha Womans University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31829b5b44"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa605"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41371\u2010021\u201000623\u20103"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279\u2010018\u20100900\u2010x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.122.318512"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2047487319877268"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.039457"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2025.133171"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.07.014"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2014.09.002"},{"issue":"18","key":"e_1_2_11_12_1","first-page":"e895","article-title":"AHA\/ACC\/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology","volume":"145","author":"Heidenreich P. 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