{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:23:17Z","timestamp":1791919397421,"version":"4.3.4"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2024,4,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>\n                      Recent guidelines redefined exercise pulmonary hypertension as a mean pulmonary artery pressure\/cardiac output (mPAP\/CO) slope &gt;3 mm\u2009Hg\u00b7L\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      . A peak systolic pulmonary artery pressure &gt;60 mm\u2009Hg during exercise has been associated with an increased risk of cardiovascular death, heart failure rehospitalization, and aortic valve replacement in aortic valve stenosis. The prognostic value of the mPAP\/CO slope in aortic valve stenosis remains unknown.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      In this prospective cohort study, consecutive patients (n=143; age, 73\u00b111 years) with an aortic valve area \u22641.5 cm\n                      <jats:sup>2<\/jats:sup>\n                      underwent cardiopulmonary exercise testing with echocardiography. They were subsequently evaluated for the occurrence of cardiovascular events (ie, cardiovascular death, heart failure hospitalization, new-onset atrial fibrillation, and aortic valve replacement) during a follow-up period of 1 year. Findings were externally validated (validation cohort, n=141).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      One cardiovascular death, 32 aortic valve replacements, 9 new-onset atrial fibrillation episodes, and 4 heart failure hospitalizations occurred in the derivation cohort, whereas 5 cardiovascular deaths, 32 aortic valve replacements, 1 new-onset atrial fibrillation episode, and 10 heart failure hospitalizations were observed in the validation cohort. Peak aortic velocity (odds ratio [OR] per SD, 1.48;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.036), indexed left atrial volume (OR per SD, 2.15;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.001), E\/e\u2019 at rest (OR per SD, 1.61;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.012), mPAP\/CO slope (OR per SD, 2.01;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002), and age-, sex-, and height-based predicted peak exercise oxygen uptake (OR per SD, 0.59;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.007) were independently associated with cardiovascular events at 1 year, whereas peak systolic pulmonary artery pressure was not (OR per SD, 1.28;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.219). Peak V\n                      <jats:sc>o<\/jats:sc>\n                      <jats:sub>2<\/jats:sub>\n                      (percent) and mPAP\/CO slope provided incremental prognostic value in addition to indexed left atrial volume and aortic valve area (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). These results were confirmed in the validation cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      In moderate and severe aortic valve stenosis, mPAP\/CO slope and percent-predicted peak V\n                      <jats:sc>o<\/jats:sc>\n                      <jats:sub>2<\/jats:sub>\n                      were independent predictors of cardiovascular events, whereas peak systolic pulmonary artery pressure was not. In addition to aortic valve area and indexed left atrial volume, percent-predicted peak V\n                      <jats:sc>o<\/jats:sc>\n                      <jats:sub>2<\/jats:sub>\n                      and mPAP\/CO slope cumulatively improved risk stratification.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.123.067130","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T05:01:05Z","timestamp":1709010065000},"page":"1172-1182","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["mPAP\/CO Slope and Oxygen Uptake Add Prognostic Value in Aortic Stenosis"],"prefix":"10.1161","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5964-6058","authenticated-orcid":true,"given":"Sarah","family":"Hoedemakers","sequence":"first","affiliation":[{"name":"Departments of Cardiology (S.H., J.S., M.F., S.M.F., G.C., L.H., J.V.), Jessa Hospital, Hasselt, Belgium."},{"name":"Faculty of Medicine and Life Sciences, UHasselt, Agoralaan, Diepenbeek, Belgium (S.H., J.S., J.C., T.G., Y.B., M.F., S.M.F., S.D., G.C., P.B., L.H., J.V.)."},{"name":"Limburg Clinical Research Center (-MHU), Hasselt, Belgium (S.H., J.S., J.C., T.G., Y.B., M.F., S.M.F., S.D., G.C., P.B., L.H., J.V.)."},{"name":"Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium (S.H., J.G., S.D., B.C., F.H.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5473-227X","authenticated-orcid":true,"given":"Nicola Riccardo","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa, Italy (N.R.P., N.D.B., L.D.P., V.D.F., S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9745-5498","authenticated-orcid":true,"given":"Jan","family":"Stassen","sequence":"additional","affiliation":[{"name":"Departments of Cardiology (S.H., J.S., M.F., S.M.F., G.C., L.H., J.V.), Jessa Hospital, Hasselt, Belgium."},{"name":"Faculty of Medicine and Life Sciences, UHasselt, Agoralaan, Diepenbeek, Belgium (S.H., J.S., J.C., T.G., Y.B., M.F., S.M.F., S.D., G.C., P.B., L.H., J.V.)."},{"name":"Limburg Clinical Research Center (-MHU), Hasselt, Belgium (S.H., J.S., J.C., T.G., Y.B., M.F., S.M.F., S.D., G.C., P.B., L.H., J.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Vanoppen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, KU Leuven, Belgium (A.V., Y.B., 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