{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T07:12:29Z","timestamp":1790493149257,"version":"4.1.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,7]]},"abstract":"\n Background<\/jats:title>\n \n Few published studies have evaluated the power of the oxygen uptake efficiency slope (\n OUES<\/jats:styled-content>\n ) to predict outcomes in patients with idiopathic pulmonary arterial hypertension (\n IPAH<\/jats:styled-content>\n ), who typically die of right\u2010sided heart failure. Our study sought to evaluate the power of\n OUES<\/jats:styled-content>\n to predict clinical worsening and mortality in patients with\n IPAH<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Patients with newly diagnosed\n IPAH<\/jats:styled-content>\n who underwent symptom\u2010limited cardiopulmonary exercise testing from November 11, 2010, to June 25, 2015, in our hospital were prospectively enrolled and followed for up to 66\u00a0months. Clinical worsening and mortality were recorded. A total of 210 patients with\n IPAH<\/jats:styled-content>\n (159 women; mean age, 32\u00b110\u00a0years) were studied with a median follow\u2010up of 41\u00a0months. Thirty\u2010one patients died, 1 patient underwent lung transplantation, and 85 patients presented with clinical worsening. The univariate analysis revealed that\n OUES<\/jats:styled-content>\n ,\n OUESI<\/jats:styled-content>\n (\n OUESI<\/jats:styled-content>\n =\n OUES<\/jats:styled-content>\n \/body surface area), peak oxygen uptake (\n \n \n \n V<\/mml:mi>\n \u02d9<\/mml:mo>\n <\/mml:mover>\n \n O<\/mml:mi>\n 2<\/mml:mn>\n <\/mml:msub>\n <\/mml:mrow>\n <\/mml:math>\n ), peak\n \n \n \n V<\/mml:mi>\n \u02d9<\/mml:mo>\n <\/mml:mover>\n \n O<\/mml:mi>\n 2<\/mml:mn>\n <\/mml:msub>\n \/<\/mml:mo>\n kg<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:math>\n , ventilation (\n \n \n \n V<\/mml:mi>\n \u02d9<\/mml:mo>\n <\/mml:mover>\n E<\/mml:mi>\n <\/mml:mrow>\n <\/mml:math>\n )\/carbon dioxide output (\n \n \n \n V<\/mml:mi>\n \u02d9<\/mml:mo>\n <\/mml:mover>\n \n CO<\/mml:mtext>\n 2<\/mml:mn>\n <\/mml:msub>\n <\/mml:mrow>\n <\/mml:math>\n ) slope, peak systolic blood pressure, heart rate recovery, pulmonary vascular resistance, cardiac index, N\u2010terminal prohormone brain natriuretic peptide, and World Health Organization functional class were all predictive of clinical worsening and mortality (all\n P<\/jats:italic>\n <0.05). Multivariate analysis demonstrated that\n OUESI<\/jats:styled-content>\n and cardiac index were independently predictive of clinical worsening, and\n OUESI<\/jats:styled-content>\n and N\u2010terminal prohormone brain natriuretic peptide were independently predictive of mortality. Patients with\n OUESI<\/jats:styled-content>\n \u22640.52\u00a0m\n \u22122<\/jats:sup>\n had a worse 5\u2010year survival rate than patients with\n OUESI<\/jats:styled-content>\n >0.52\u00a0m\n \u22122<\/jats:sup>\n (41.9% versus 89.8%,\n P<\/jats:italic>\n <0.0001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The\n OUES<\/jats:styled-content>\n , a submaximal parameter obtained from cardiopulmonary exercise testing, provides prognostic information for predicting clinical worsening and mortality in patients with\n IPAH<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.005037","type":"journal-article","created":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T00:40:22Z","timestamp":1498869622000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Oxygen Uptake Efficiency Slope Predicts Poor Outcome in Patients With Idiopathic Pulmonary Arterial Hypertension"],"prefix":"10.1161","volume":"6","author":[{"given":"Yi","family":"Tang","sequence":"first","affiliation":[{"name":"Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Luo","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihong","family":"Liu","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuping","family":"Ma","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Zhao","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwei","family":"Huang","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu","family":"Gao","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Jin","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changming","family":"Xiong","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinhai","family":"Ni","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 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