{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:50:00Z","timestamp":1792623000579,"version":"4.5.0"},"reference-count":37,"publisher":"Japanese Circulation Society","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Circ J"],"published-print":{"date-parts":[[2019,11,25]]},"DOI":"10.1253\/circj.cj-19-0699","type":"journal-article","created":{"date-parts":[[2019,11,7]],"date-time":"2019-11-07T22:04:19Z","timestamp":1573164259000},"page":"2487-2493","source":"Crossref","is-referenced-by-count":13,"title":["H&lt;sub&gt;2&lt;\/sub&gt;FPEF Score for the Prediction of Exercise Intolerance and Abnormal Hemodynamics in Japanese\u3000\u2015 Evaluation by Exercise Stress Echocardiography Combined With Cardiopulmonary Exercise Testing \u2015"],"prefix":"10.1253","volume":"83","author":[{"given":"Kosuke","family":"Takahari","sequence":"first","affiliation":[{"name":"Shobara-city Soryo Clinic"},{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Hidaka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanako","family":"Izumi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Harada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Susawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirai","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences"},{"name":"Department of Cardiovascular Medicine, Shobara Red Cross Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiho","family":"Itakura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Utsunomiya","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuki","family":"Kihara","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"330","reference":[{"key":"1","doi-asserted-by":"crossref","unstructured":"1. Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. <i>N Engl J Med<\/i> 2006; 355: 251\u2013259.","DOI":"10.1056\/NEJMoa052256"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2. Shiba N, Nochioka K, Miura M, Kohno H, Shimokawa H; CHART-2 Investigators. Trend of westernization of etiology and clinical characteristics of heart failure patients in Japan: First report from the CHART-2 study. <i>Circ J<\/i> 2011; 75: 823\u2013833.","DOI":"10.1253\/circj.CJ-11-0135"},{"key":"3","doi-asserted-by":"crossref","unstructured":"3. Bleumink GS, Knetsch AM, Sturkenboom MC, Straus SM, Hofman A, Deckers JW, et al. Quantifying the heart failure epidemic: Prevalence, incidence rate, lifetime risk and prognosis of heart failure. The Rotterdam Study. <i>Eur Heart J<\/i> 2004; 25: 1614\u20131619.","DOI":"10.1016\/j.ehj.2004.06.038"},{"key":"4","doi-asserted-by":"crossref","unstructured":"4. Yasuda S, Nakao K, Nishimura K, Miyamoto Y, Sumita Y, Shishido T, et al. The current status of cardiovascular medicine in Japan: Analysis of a large number of health records from a nationwide claim-based database, JROAD-DPC. <i>Circ J<\/i> 2016; 80: 2327\u20132335.","DOI":"10.1253\/circj.CJ-16-0196"},{"key":"5","unstructured":"5. Cabinet Office. Annual Report on the Aging Society: 2018 (Summary). https:\/\/www8.cao.go.jp\/kourei\/english\/annualreport\/2018\/2018pdf_e.html (accessed July 8, 2019)."},{"key":"6","doi-asserted-by":"crossref","unstructured":"6. Okura Y, Ramadan MM, Ohno Y, Mitsuma W, Tanaka K, Ito M, et al. Impending epidemic: Future projection of heart failure in Japan to the year 2055. <i>Circ J<\/i> 2008; 72: 489\u2013491.","DOI":"10.1253\/circj.72.489"},{"key":"7","doi-asserted-by":"crossref","unstructured":"7. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. <i>Eur J Heart Fail<\/i> 2016; 18: 891\u2013975.","DOI":"10.1002\/ejhf.592"},{"key":"8","doi-asserted-by":"crossref","unstructured":"8. Nadrus W Jr, West E, Sengel\u00f8v M, Santos M, Groarke JD, Forman DE, et al. Prognostic value of cardiopulmonary exercise testing in heart failure with reduced, midrange, and preserved ejection fraction. <i>J Am Heart Assoc<\/i> 2017; 6: e006000.","DOI":"10.1161\/JAHA.117.006000"},{"key":"9","doi-asserted-by":"crossref","unstructured":"9. Guazzi M, Myers J, Arena R. Cardiopulmonary exercise testing in the clinical and prognostic assessment of diastolic heart failure. <i>J Am Coll Cardiol<\/i> 2005; 46: 1883\u20131890.","DOI":"10.1016\/j.jacc.2005.07.051"},{"key":"10","doi-asserted-by":"crossref","unstructured":"10. Sullivan MJ, Hawthorne MH. Exercise intolerance in patients with chronic heart failure. <i>Prog Cardiovasc Dis<\/i> 1995; 38: 1\u201322.","DOI":"10.1016\/S0033-0620(05)80011-8"},{"key":"11","doi-asserted-by":"crossref","unstructured":"11. Reddy YNV, Olson TP, Obokata M, Melenovsky V, Borlaug BA. Hemodynamic correlates and diagnostic role of cardiopulmonary exercise testing in heart failure with preserved ejection fraction. <i>JACC Heart Fail<\/i> 2018; 6: 665\u2013675.","DOI":"10.1016\/j.jchf.2018.03.003"},{"key":"12","doi-asserted-by":"crossref","unstructured":"12. Borlaug BA, Nishimura RA, Sorajja P, Lam CS, Redfield MM. Exercise hemodynamics enhance diagnosis of early heart failure with preserved ejection fraction. <i>Circ Heart Fail<\/i> 2010; 3: 588\u2013595.","DOI":"10.1161\/CIRCHEARTFAILURE.109.930701"},{"key":"13","doi-asserted-by":"crossref","unstructured":"13. Maron BA, Cockrill BA, Waxman AB, Systrom DM. The invasive cardiopulmonary exercise test. <i>Circulation<\/i> 2013; 127: 1157\u20131164.","DOI":"10.1161\/CIRCULATIONAHA.112.104463"},{"key":"14","doi-asserted-by":"crossref","unstructured":"14. Obokata M, Kane GC, Reddy YN, Olson TP, Melenovsky V, Borlaug BA. Role of diastolic stress testing in the evaluation for heart failure with preserved ejection fraction: A simultaneous invasive-echocardiographic study. <i>Circulation<\/i> 2017; 135: 825\u2013838.","DOI":"10.1161\/CIRCULATIONAHA.116.024822"},{"key":"15","doi-asserted-by":"crossref","unstructured":"15. Nagueh SF, Smiseth OA, Appleton CP, Byrd BF, Dokainish H, Edvardsen T, et al. ASE\/EACVI Guidelines and Standards. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. <i>J Am Soc Echocardiogr<\/i> 2016; 29: 277\u2013314.","DOI":"10.1016\/j.echo.2016.01.011"},{"key":"16","doi-asserted-by":"crossref","unstructured":"16. Burgess MI, Jenkins MC, Sharman JE, Marwick TH. Diastolic stress echocardiography: Hemodynamic validation and clinical significance of estimation of ventricular filling pressure with exercise. <i>J Am Coll Cardiol<\/i> 2006; 47: 1891\u20131900.","DOI":"10.1016\/j.jacc.2006.02.042"},{"key":"17","doi-asserted-by":"crossref","unstructured":"17. Shim CY, Kim SA, Choi D, Yang WI, Kim JM, Moon SH, et al. Clinical outcomes of exercise-induced pulmonary hypertension in subjects with preserved left ventricular ejection fraction: Implication of an increase in left ventricular filling pressure during exercise. <i>Heart<\/i> 2011; 97: 1417\u20131424.","DOI":"10.1136\/hrt.2010.220467"},{"key":"18","doi-asserted-by":"crossref","unstructured":"18. Lam CSP, Roger VI, Rodeheffer RJ, Borlaug BA, Enders FT, Redfeld MM. Pulmonary hypertension in heart failure with preserved ejection fraction. <i>J Am Coll Cardiol<\/i> 2009; 53: 1119\u20131126.","DOI":"10.1016\/j.jacc.2008.11.051"},{"key":"19","doi-asserted-by":"crossref","unstructured":"19. Reddy YNV, Carter RE, Obokata M, Redfield MM, Borlaug BA. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. <i>Circulation<\/i> 2018; 138: 861\u2013870.","DOI":"10.1161\/CIRCULATIONAHA.118.034646"},{"key":"20","doi-asserted-by":"crossref","unstructured":"20. Stelken AM, Younis LT, Jennison SH, Miller DD, Miller LW, Shaw LJ, et al. Prognostic value of cardiopulmonary exercise testing using percent achieved of predicted peak oxygen uptake for patients with ischemic and dilated cardiomyopathy. <i>J Am Coll Cardiol<\/i> 1996; 27: 345\u2013352.","DOI":"10.1016\/0735-1097(95)00464-5"},{"key":"21","doi-asserted-by":"crossref","unstructured":"21. Guazzi M, Arena R, Halle M, Piepoli MF, Myers J, Lavie CJ. 2016 Focused update: Clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. <i>Circulation<\/i> 2016; 133: e694\u2013e711.","DOI":"10.1161\/CIR.0000000000000406"},{"key":"22","unstructured":"22. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. <i>J Am Soc Echocardiogr<\/i> 2015; 16: 233\u2013270."},{"key":"23","doi-asserted-by":"crossref","unstructured":"23. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: A report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. <i>J Am Soc Echocardiogr<\/i> 2010; 23: 685\u2013713.","DOI":"10.1016\/j.echo.2010.05.010"},{"key":"24","doi-asserted-by":"crossref","unstructured":"24. Kanda Y. Investigation of the freely available easy-to-use software \u2018EZR\u2019 for medical statistics. <i>Bone Marrow Transplantat<\/i> 2013; 48: 452\u2013458.","DOI":"10.1038\/bmt.2012.244"},{"key":"25","unstructured":"25. Japanese Circulation Society. Guidelines for pharmacotherapy of atrial fibrillation (JCS 2013). Tokyo: Japanese Circulation Society, 2013 [in Japanese]. http:\/\/www.j-circ.or.jp\/guideline\/pdf\/JCS2013_inoue_h.pdf (accessed September 5, 2019)."},{"key":"26","unstructured":"26. Japanese Circulation Society. Guidelines for diagnosis and treatment of acute and chronic heart failure (JCS 2017\/JHFS 2017). Tokyo: Japanese Circulation Society, 2018 [in Japanese]. http:\/\/www.asas.or.jp\/jhfs\/pdf\/topics20180323.pdf (accessed July 9, 2019)."},{"key":"27","doi-asserted-by":"crossref","unstructured":"27. Mohammed SF, Borlaug BA, McNulty S, Lewis GD, Lin G, Zakeri R, et al. Resting ventricular-vascular function and exercise capacity in heart failure with preserved ejection fraction: A RELAX Trial ancillary study. <i>Circ Heart Fail<\/i> 2014; 7: 580\u2013589.","DOI":"10.1161\/CIRCHEARTFAILURE.114.001192"},{"key":"28","doi-asserted-by":"crossref","unstructured":"28. Lam CS, Rienstra M, Tay WT, Liu LC, Hummel YM, van der Meer P, et al. Atrial fibrillation in heart failure with preserved ejection fraction: Association with exercise capacity, left ventricular filling pressures, natriuretic peptides, and left atrial volume. <i>JACC Heart Fail<\/i> 2017; 5: 92\u201398.","DOI":"10.1016\/j.jchf.2016.10.005"},{"key":"29","doi-asserted-by":"crossref","unstructured":"29. Obokata M, Olson TP, Reddy YNV, Melenovsky V, Kane GC, Borlaug BA. Hemodynamics, dyspnea, and pulmonary reserve in heart failure with preserved ejection fraction. <i>Eur Heart J<\/i> 2018; 39: 2810\u20132821.","DOI":"10.1093\/eurheartj\/ehy268"},{"key":"30","doi-asserted-by":"crossref","unstructured":"30. Ha JW, Choi D, Park S, Shim CY, Kim JM, Moon SH, et al. Determinants of exercise-induced pulmonary hypertension in patients with normal left ventricular ejection fraction. <i>Heart<\/i> 2009; 95: 490\u2013494.","DOI":"10.1136\/hrt.2007.139295"},{"key":"31","doi-asserted-by":"crossref","unstructured":"31. Metra M, Teerlink JR. Heart failure. <i>Lancet<\/i> 2017; 390: 1981\u20131995.","DOI":"10.1016\/S0140-6736(17)31071-1"},{"key":"32","doi-asserted-by":"crossref","unstructured":"32. Pandey A, Parashar A, Kumbhani D, Agarwal S, Garg J, Kitzman D, et al. Exercise training in patients with heart failure and preserved ejection fraction: Meta-analysis of randomized control trials. <i>Circ Heart Fail<\/i> 2015; 8: 33\u201340.","DOI":"10.1161\/CIRCHEARTFAILURE.114.001615"},{"key":"33","doi-asserted-by":"crossref","unstructured":"33. Claessen G, La Gerche A, Voigt JU, Dymarkowski S, Schnell F, Petit T, et al. Accuracy of echocardiography to evaluate pulmonary vascular and RV function during exercise. <i>JACC Cardiovasc Imaging<\/i> 2016; 9: 532\u2013543.","DOI":"10.1016\/j.jcmg.2015.06.018"},{"key":"34","doi-asserted-by":"crossref","unstructured":"34. van Riel AC, Opotowsky AR, Santos M, Rivero JM, Dhimitri A, Mulder BJ, et al. Accuracy of echocardiography to estimate pulmonary artery pressures with exercise: A simultaneous invasive-noninvasive comparison. <i>Circ Cardiovasc Imaging<\/i> 2017; 10: e005711.","DOI":"10.1161\/CIRCIMAGING.116.005711"},{"key":"35","doi-asserted-by":"crossref","unstructured":"35. Utsunomiya H, Hidaka T, Susawa H, Izumi K, Harada Y, Kinoshita M, et al. Exercise-stress echocardiography and effort intolerance in asymptomatic\/minimally symptomatic patients with degenerative mitral regurgitation combined invasive-noninvasive hemodynamic monitoring. <i>Circ Cardiovasc Imaging<\/i> 2018; 11: e007282.","DOI":"10.1161\/CIRCIMAGING.117.007282"},{"key":"36","doi-asserted-by":"crossref","unstructured":"36. Wierzbowska-Drabik K, Picano E, Bossone E, Ciampi Q, Lipiec P, Kasprzak JD. The feasibility and clinical implication of tricuspid regurgitant velocity and pulmonary flow acceleration time evaluation for pulmonary pressure assessment during exercise stress echocardiography. <i>Eur Heart J Cardiovasc Imaging<\/i> 2019; 20: 1027\u20131034.","DOI":"10.1093\/ehjci\/jez029"},{"key":"37","doi-asserted-by":"crossref","unstructured":"37. Lopes LR, Loureiro MJ, Miranda R, Almeida S, Almeida AR, Cordeiro A, et al. The usefulness of contrast during exercise echocardiography for the assessment of systolic pulmonary pressure. <i>Cardiovasc Ultrasound<\/i> 2008; 6: 51.","DOI":"10.1186\/1476-7120-6-51"}],"container-title":["Circulation Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/circj\/83\/12\/83_CJ-19-0699\/_pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T12:09:08Z","timestamp":1575288548000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/circj\/83\/12\/83_CJ-19-0699\/_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,25]]},"references-count":37,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1253\/circj.cj-19-0699","relation":{},"ISSN":["1346-9843","1347-4820"],"issn-type":[{"value":"1346-9843","type":"print"},{"value":"1347-4820","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,25]]}}}