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August 24, 2026Acta cardiologica. Supplementum

Impact of systemic inflammation on exercise haemodynamics in unexplained dyspnoea and heart failure with preserved ejection fraction

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Why the study?

Systemic inflammation in HFpEF predicts worse outcomes, but its impact on exercise haemodynamics in patients with unexplained dyspnoea required investigation.

Does systemic inflammation impact exercise haemodynamics and capacity in patients with unexplained dyspnoea and HFpEF?

Population

191 consecutively evaluated subjects referred for unexplained dyspnoea

Comparison

Systemic inflammation (hs-CRP ≥2 mg/L) vs no systemic inflammation

Design

Prospective cohort study

Key result

In subjects with unexplained dyspnoea, systemic inflammation was associated with lower peak oxygen consumption (16.9 vs. 20.6 mL/min/kg; p<0.001) and impaired right ventricular reserve.

Authors

GMG.M. MondelliniJHJannik HeemannXGXavier Galloo

Discussion

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Member takes

Overview

Suggests an inflammatory phenotype drives exertional intolerance in HFpEF; leaves open.

Study Design

Type

Cohort (n=191)

Multicenter

No

Structured PICO

Does systemic inflammation impact exercise haemodynamics and capacity in patients with unexplained dyspnoea and HFpEF?

P
Population
191 subjects referred for unexplained dyspnoea evaluated with cardiopulmonary exercise testing and concomitant exercise echocardiography.
E
Exposure
Systemic inflammation (defined as high-sensitivity C-reactive protein level ≥2 mg/L)
C
Comparator
No systemic inflammation
O
Outcome
Exercise haemodynamics and peak oxygen consumptionsurrogate

Main Result

Absolute Event Rate: 16.9% vs 20.6%

p-value: p=<0.001

In patients with unexplained dyspnoea, systemic inflammation is associated with reduced exercise capacity and impaired right ventricular contractile reserve.

Cite This Study

Mondellini et al. (2026) conducted a cohort in Unexplained dyspnoea and heart failure with preserved ejection fraction (n=191). Systemic inflammation (hs-CRP ≥2 mg/L) vs. Without systemic inflammation was evaluated on Peak oxygen consumption (mL/min/kg) (p=<0.001). In subjects with unexplained dyspnoea, systemic inflammation was associated with lower peak oxygen consumption (16.9 vs. 20.6 mL/min/kg; p<0.001) and impaired right ventricular reserve.

synapsesocial.com/papers/6a8e7d30e3420198dacd684ehttps://doi.org/10.1080/00015385.2026.2721796
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Impact of Voluntary Exercise on Systemic Inflammation in a 2? Hit Model of Heart Failure With Preserved Ejection Fraction2025
  2. 2Changes in Cardiopulmonary Reserve and Peripheral Arterial Function Concomitantly with Subclinical Inflammation and Oxidative Stress in Patients with Heart Failure with Preserved Ejection Fraction2014 · 17 citations
  3. 3Association of Systemic Inflammation Level on Admission with Total and Cardiovascular‑Specific Death in Heart Failure with Preserved Ejection Fraction: A Large Multi‑Center Retrospective Longitudinal Study2024 · 4 citations
  4. 4Exercise cardiopulmonary magnetic resonance imaging unmasks worsening cardiovascular haemodynamics in the spectrum of heart failure with preserved ejection fraction (HFpEF)2025
  5. 5Heart failure risk stratification using the HFA-PEFF scale in patients with arterial hypertension after COVID-19: the role of inflammatory status and identification of the most vulnerable group2026