Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Exercise PH poised for comeback as new definition takes hold

Key clinical point: It’s not the stand-alone pulmonary artery pressure that matters on exercise testing, but the slope of PAP to cardiac output.

Major finding: A pulmonary artery pressure/cardiac output slope greater than 3 mm Hg/L/min on cardiopulmonary exercise tests more than doubled the risk of cardiovascular hospitalization and all-cause mortality.

Study details: Prospective, single-center study of 714 people with exertional dyspnea but preserved ejection fractions.

Disclosures: The work was funded by the National Institutes of Health, Gilead Sciences, the American Heart Association, and the Massachusetts General Hospital Heart Failure Research Innovation Fund. The investigators had no relevant disclosures.


Ho JE et al. J Am Coll Cardiol. 2020 Jan 7;75[1]:17-26. doi: 10.1016/j.jacc.2019.10.048.