{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T14:34:57Z","timestamp":1789223697845,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["23CDA1057697"],"award-info":[{"award-number":["23CDA1057697"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiological Reports"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Poor recovery pattern of oxygen consumption (V\u0307O<jats:sub>2<\/jats:sub>) post\u2010exercise is associated with adverse clinical outcomes. However, it remains unknown which component of the O<jats:sub>2<\/jats:sub> pathway (Fick principle) defines this prognostic risk, for example, peripheral extraction, stroke volume, heart rate. Retrospective cohort study included 120 participants (heart failure with preserved ejection fraction: HFpEF\u2009=\u200968, pre\u2010capillary pulmonary hypertensio <jats:italic>n<\/jats:italic>\u2009=\u200931, non\u2010cardiac dyspnea\u2009=\u200921). Percent recovery metrics were calculated as the percent reduction of each hemodynamic variable from peak exercise to recovery, for example, (exercise\u2010recovery)\/exercise \u00d7100%. Overall, the mean age (standard deviation) was 62.6 (14.4) years and 54% were females. Among the three groups (HFpEF, pre\u2010capillary pulmonary hypertension, non\u2010cardiac dyspnea), recovery patterns of O<jats:sub>2<\/jats:sub> pathway components were statistically non\u2010significant. Peripheral extraction recovery (<jats:italic>r<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.43, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and heart rate recovery (<jats:italic>r<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.25, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) correlated with peak V\u0307O<jats:sub>2<\/jats:sub>, but only peripheral extraction recovery remained significant in multivariate analysis (<jats:italic>p<\/jats:italic>\u2009=\u20090.01). Peripheral extraction recovery (&lt;41%; median) demonstrated poor one\u2010year survival from mortality and heart failure hospitalizations (HR 2.82; CI 95% 1.38\u20135.74, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). Peripheral extraction recovery pattern is the most significant component of the O<jats:sub>2<\/jats:sub> pathway and defines adverse outcomes. Physiologically, it elucidates the importance of skeletal muscle and peripheral vascular function.<\/jats:p>","DOI":"10.14814\/phy2.70337","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T02:47:56Z","timestamp":1744598876000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Breaking down the recovery of <scp>O<sub>2<\/sub><\/scp> pathway: Peripheral extraction recovery pattern defines exercise capacity and clinical outcomes"],"prefix":"10.14814","volume":"13","author":[{"given":"Ahmed","family":"El Shaer","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Garcia\u2010Arango","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Division of Cardiovascular Medicine, School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anas","family":"Abed","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Heffernan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuning","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Statistics, School of Computer, Data &amp; Information University of Wisconsin\u2010Madison  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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5750-2034","authenticated-orcid":false,"given":"Farhan","family":"Raza","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwae203"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2018.01.007"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.112.000157"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.114.001825"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029058"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00879\u20102022"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735\u20101097(91)90832\u2010T"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00004.2014"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20707"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2020.03.008"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.005505"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23831"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.005037"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.123.010826"}],"container-title":["Physiological 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