{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:44:59Z","timestamp":1753883099731,"version":"3.41.2"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,3,19]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Cardiopulmonary exercise test (CPET) with supine bicycle echocardiography (SBE) enables comprehensive physiologic assessment during exercise. We characterized cardiopulmonary fitness by integrating CPET\u2010SBE parameters and evaluated its prognostic value in patients presenting with dyspnea.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We retrospectively reviewed 473 consecutive patients who underwent CPET\u2010SBE for dyspnea evaluation. A dimensionality reduction process was applied, transforming 24 clinical and CPET\u2010SBE parameters into a 2\u2010dimensional feature map, followed by patient clustering based on the data distribution. Clinical and exercise features were compared among the clusters in addition to the 5\u2010year risk of clinical outcome (a composite of cardiovascular death and heart failure hospitalization). Maximum exercise effort (\n              <jats:italic>R<\/jats:italic>\n              &gt;1) was achieved in 95% of cases. Through dimensionality reduction, 3 patient clusters were derived: Group 1 (n=157), 2 (n=104), and 3 (n=212). Median age and female proportion increased from Group 1 to 2, and 3, although resting echocardiography parameters showed no significant abnormalities among the groups. There was a worsening trend in the exercise response from Group 1 to 2 and 3, including left ventricular diastolic function, oxygen consumption, and ventilatory efficiency. During follow\u2010up (median 6.0 [1.6\u201310.4] years), clinical outcome increased from Group 1 to 2 and 3 (5\u2010year rate 3.7% versus 7.0% versus 13.0%, respectively; log\u2010rank\n              <jats:italic>P<\/jats:italic>\n              =0.02), with higher risk in Group 2 (hazard ratio, 1.94 [95% CI, 0.52\u20137.22]) and Group 3 (3.92 [1.34\u201311.42]) compared with Group 1.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Comprehensive evaluation using CPET\u2010SBE can reveal distinct characteristics of cardiopulmonary fitness in patients presenting with dyspnea, potentially enhancing outcome prediction.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.033815","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T02:11:33Z","timestamp":1710295893000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Integrative Assessment of Cardiopulmonary Fitness Using Cardiopulmonary Exercise Test With Supine Bicycle Echocardiography in Patients Presenting Dyspnea"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6924-7106","authenticated-orcid":false,"given":"Jiesuck","family":"Park","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cardiovascular Center Seoul National University Bundang Hospital Seongnam Gyeonggi\u2010do Republic of Korea"},{"name":"Department of Internal Medicine Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7910-1219","authenticated-orcid":false,"given":"Houng\u2010Beom","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Center Seoul National University Bundang Hospital Seongnam Gyeonggi\u2010do Republic of Korea"},{"name":"Department of Internal Medicine Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3157-0247","authenticated-orcid":false,"given":"Hyejung","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Center Seoul National University Bundang Hospital Seongnam Gyeonggi\u2010do Republic of Korea"},{"name":"Department of Internal Medicine Seoul National University College of Medicine Seoul Republic of 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Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8479-9889","authenticated-orcid":false,"given":"Yeonyee E.","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Center Seoul National University Bundang Hospital Seongnam Gyeonggi\u2010do Republic of Korea"},{"name":"Department of Internal Medicine Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7067-5535","authenticated-orcid":false,"given":"Goo\u2010Yeong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Center Seoul National University Bundang Hospital Seongnam Gyeonggi\u2010do Republic of Korea"},{"name":"Department of Internal Medicine Seoul National University College of Medicine Seoul Republic of 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