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Abstract Background Coughing is frequently linked to urinary incontinence (UI) in women. However, there is few information about its actual prevalence among women with chronic cough. There are some previous studies that link urinary incontinence to the occupational status. Aim of work To measure the prevalence of stress urinary incontinence and to identify the relationship between urinary incontinence and occupational status among female patients with chronic cough. Materials and methods A cross-sectional study was conducted on 80 female patients presented with chronic cough of any cause, and all patients were interviewed using a structured questionnaire that included personal, occupational, chronic cough, and urinary incontinence questionnaire. General and local examination were done. Results Out of 80 patients, 55% were found to have stress urinary incontinence. Gastroesophageal reflux disease (GERD) was the most prevalent cause of chronic cough (48.8%) followed by bronchial asthma (22.5%). Most of the studied patients (90.9%) reported that leaking of urine interferes with their quality of life. The frequency of UI among working females was significantly higher than nonworkers. Occupations requiring physical activity had significantly higher frequency of UI than those without. Other environmental work conditions as unclean or uncomfortable workplaces had no significant relationship with UI. Menopause patients had 2.8 times higher risk to develop UI. The mean age, mean number of parities, vaginal delivery, median duration of cough, cough severity index, and cough visual analogue scale were significantly higher in UI patients. The logistic regression was performed to test effects of different risk factors on UI. Results indicated that age, type of occupations according to physical activity, and cough severity index were independently statistically significant risk factors for UI in female patients with chronic cough. Conclusion UI is common in female patients with chronic cough (55%). Age, type of occupations according to physical activity, and cough severity index were independently significant risk factors for UI in female patients with chronic cough.

Parallel delta robots are widely used in industrial automation for high-speed, high-precision tasks such as pick-and-place operations. However, traditional control methods like Proportional-Derivative (PD) controllers often struggle to handle the nonlinear dynamics of these systems, leading to suboptimal performance and stability issues. This study proposes an innovative control framework that combines a PD-type controller with a State-Dependent Riccati Equation (SDRE) approach, augmented by Iterative Learning Control (ILC), to address these challenges. The SDRE framework dynamically adjusts system parameters to enhance stability margins, while the ILC component iteratively refines control inputs based on error patterns, achieving progressively improved precision. The proposed method was validated through both simulations and experimental testing on a parallel delta robot, focusing on regulation and tracking tasks. The experimental setup included a mechanical manipulator controlled via the hybrid SDRE-ILC framework, with performance benchmarks compared to traditional PD controllers. Results demonstrated an 85 % reduction in system errors across successive iterations, confirming the efficacy of the approach. The hybrid framework not only improved stability and tracking accuracy but also provided adaptability to dynamic conditions. This study offers a robust and scalable solution for enhancing the performance of parallel delta robots, particularly in applications demanding high precision and reliability, such as assembly lines, packaging, and surgical robotics. The findings emphasize the potential of integrating advanced control strategies to overcome the inherent limitations of conventional methods, paving the way for more efficient industrial automation systems.

Background Dead space refers to the part of each tidal volume that does not contribute to gas exchange. It serves as an indicator of lung function efficiency. Aim To evaluate the end-tidal-to-arterial PCO2 ratio and Acute Physiological and Chronic Health Assessment (APACHE IV) scoring system as prognostic values in mechanically ventilated patients at the respiratory intensive care unit (ICU). Patients and methods This prospective cohort research was done on 40 mechanically ventilated patients due to different respiratory causes who were admitted at the respiratory ICU at Ain Shams University hospitals. Results This study found that decreasing end tidal PCO2 (PETCO2)/arterial carbon dioxide (PaCO2) is associated with higher mortality amongst mechanically ventilated cases in respiratory ICU. A significant negative association between APACHE IV score and end-tidal to arterial PCO2 ratio following 1 h and after 24 h of mechanical ventilation. APACHE IV score showed a significant relation with mortality, being higher in survivors than nonsurvivors. Conclusion PETCO2/PaCO2 is a relevant prognostic value that reflects dead space ventilation among mechanically ventilated patients in respiratory ICU. APACHE IV score is a good mortality predictor in respiratory ICU.

IntroductionPhysical training induces iron status impairment in athletic females in the short term and over prolonged periods. Nevertheless, the existing literature lacks a comprehensive evaluation of the differential impacts of aerobic vs. anaerobic training on hematological indices and iron status among adolescent female athletes. The aim of this study was to assess the hematological factors and iron status in aerobic vs. anaerobic training in athletic females.MethodsThis observational, cross-sectional study recruited twenty-five adolescent athletic females; thirteen of them participated in an aerobic sport (long-distance running), while twelve of them participated in an anaerobic sport (broad jumping). Hematological factors were assessed by analyzing blood concentrations of hemoglobin (Hb), hematocrit (Hct), red blood cell (RBC) count, mean corpuscular volume (MCV), and mean corpuscular hemoglobin concentration (MCHC), while the iron status assessment was conducted through evaluating levels of serum transferrin and serum ferritin.ResultsAthletic females who participated in the aerobic sport showed significantly lower Hb (MD −0.84; 95% CI −1.63: −0.04; p = 0.041), Hct (MD −5.49; 95% CI −7.86: −3.12; p = 0.0001), RBC count (MD −0.37; 95% CI −0.57: −0.17; p = 0.001), and MCV (MD −5.15; 95% CI −9.41: −0.89; p = 0.020), as well as significantly higher MCHC (MD 2.99; 95% CI 2.18: 3.79; p = 0.0001) and serum transferrin (MD 46.77; 95% CI 10.95: 82.59; p = 0.013) than athletic females who participated in the anaerobic sport. However, there was an insignificant difference in serum ferritin levels (MD −3.18; 95% CI −11.49: 5.13; p = 0.437) between both groups.ConclusionExcept for the ferritin level that exhibited an insignificant difference between aerobic and anaerobic training, aerobic training was associated with a worse impact on the hematological factors and iron status than anaerobic training in adolescent athletic females.

The main topic of this paper is how to develop pick and place delta robot with high efficiency mechanical parts and prosaically assemble it, additionally built electrical wiring diagram all of this supported by vision computer system. The system has a low-cost part and solves many problems to build this robot. Electrical section has two main components master and slave the master is raspberry pi and slave is Arduino, master is used to vision detect object and Arduino is used to invers kinematics equation, move motors to target position, control in hydraulic system to pull the object with suction cup. The process of vison system is passing through some steps, detect the object by color range, contouring box then send the real position to an Arduino. The experimental process proved the effectiveness and accuracy of the delta robot vision system in the sorting process from conveyor system. The target of system that function is applied with a low cost.

Background Known as severe acute respiratory syndrome coronavirus 2, the severe acute respiratory syndrome coronavirus is a new coronavirus illness [coronavirus disease-2019 (COVID-19)], it spreads quickly over the world. Patients with COVID-19 frequently have changes in platelet count. The platelet count is a highly useful clinical tool for tracking patients with aggressive viral infections who have rapidly changing health conditions since it is a sensitive indicator of sickness severity. Aim To study thrombocytopenia as a prognostic factor in COVID-19 patients and its relation with the length of hospital stay and prognosis. Patients and methods A total of 60 COVID-19 patients were involved in the prospective study during the period from June 2020 to December 2020 who were admitted to the isolation hospital, Ain Shams University Hospitals. Then for each patient, complete blood count at admission was done, repeated on day 7, day 14, and day 21. Patients were followed regarding the length of hospital stay and mortality. Results Out of 60 patients, 10 (16.6%) patients were thrombocytopenic. The length of hospital stay was significantly higher in a thrombocytopenic group. There was a high statistically significant difference between the normal platelets count group and the thrombocytopenic groups regarding outcome (P

Copyright of Egyptian Journal of Bronchology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Aims A method for estimating right ventricular ejection fraction (RVEF) from RV pressure waveforms was recently validated in an experimental model. Currently, cardiac magnetic resonance imaging (MRI) is the clinical reference standard for measurement of RVEF in pulmonary arterial hypertension (PAH). The present study was designed to test the hypothesis that the pressure‐based method can detect clinically significant reductions in RVEF as determined by cardiac MRI in patients with PAH. Methods and results RVEF estimates derived from analysis of RV pressure waveforms recorded during right heart catheterization (RHC) in 25 patients were compared with cardiac MRI measurements of RVEF obtained within 24 h. Three investigators blinded to cardiac MRI results independently performed pressure‐based RVEF estimation with the mean of their results used for comparison. Linear regression was used to assess correlation, and a receiver operator characteristic (ROC) curve was derived to define ability of the pressure‐based method to detect a maladaptive RV response, defined as RVEF

Abstract Objective Many studies still dispute the identification of independent risk factors that influence outcome after neonatal cardiac surgery. We present our study to announce the contemporary outcomes and risk profile of neonatal cardiac surgery at our institute. Methods We designed a retrospective study of neonatal patients who underwent surgery for congenital heart diseases between June 2011 and April 2020. Demographic, operative, and postoperative data were collected from medical records and surgical databases. The primary outcome was the operative mortality (in-hospital death) and secondary outcomes included hospital length of stay, intensive care unit stay, duration of mechanical ventilation. Results In total, 1155 cardiac surgeries in children were identified; of these, 136 (11.8%) were performed in neonates. Arterial switch operations (48 cases) were the most frequent procedures. Postoperatively, 11 (8.1%) patients required extracorporeal membrane oxygenation, and 4 (2.9%) patients had complete heart block. Postoperative in-hospital mortality was 11%. The median postoperative duration of mechanical ventilation, intensive care unit stay, and hospital length of stay were 6, 18, and 24 days, respectively. Conclusion The early outcomes of neonatal cardiac surgery are encouraging. The requirement of postoperative extracorporeal membrane oxygenation support, postoperative intracranial hemorrhage, and acute kidney were identified as independent risk factors of mortality following surgery for congenital heart defects in neonates.

Background: Since the Ministry of Health and Population [MOHP] in Egypt had declared the appearance of the first COVID- 19 confirmed case in Egypt on February 14, 2020. Strict measures were taken to control the virus spread, including the identification of some centers for triage and others for quarantine.The aim of the work: The goal of our research was to determine the clinical and hematological results of COVID-19 confirmed patients at two specialized triage hospitals.Patients and Methods: This was an observational prospective cohort in which we included all adult patients with laboratory-confirmed COVID-19 by RT-PCR of samples taken by nasopharyngeal swabs attended to two Egyptian hospitals that, assigned by MOHP as a triage center for COVID-19, in the period between 5th April to 27th August 2020. The clinical characteristics and hematological findings at presentation were studied.Results: This study included 200 consecutive COVID-19 confirmed patients from both hospitals, fever [75%] was the main presenting symptom followed by cough [71%] then dyspnea [20%]. [41%] of the patients had lymphopenia, [5%] had lymphocytosis, [11.5%] had neutrophilia, [2%] had thrombocytopenia, and [30.5%] had anemia.Conclusion: COVID-19 could be presented typically by pulmonary or atypically by various extrapulmonary manifestations in addition to different hematological laboratory findings.

Abstract Background Knowledge about the outcome of COVID-19 on pregnant women is so important. The published literature on the outcomes of pregnant women with COVID-19 is confusing. The aim of this study was to report our clinical experience about the effect of COVID-19 on pregnant women and to determine whether it was associated with increased mortality or an increase in the need for mechanical ventilation in this special category of patients. Methods This was a cohort study from some isolation hospitals of the Ministry of Health and Population, in eleven governorates, Egypt. The clinical data from the first 64 pregnant women with COVID-19 whose care was managed at some of the Egyptian hospitals from 14 March to 14 June 2020 as well as 114 non-pregnant women with COVID-19 was reviewed. Results The two groups did not show any significant difference regarding the main outcomes of the disease. Two cases in each group needed mechanical ventilation (p 0.617). Three cases (4.7%) died among the pregnant women and two (1.8%) died among the non-pregnant women (p 0.352). Conclusions The main clinical outcomes of COVID-19 were not different between pregnant and non-pregnant women with COVID-19. Based on our findings, pregnancy did not exacerbate the course or mortality of COVID-19 pneumonia.

Introduction: Physical training induces iron status impairment in athletic females in the short term and over prolonged periods. Nevertheless, the existing literature lacks a comprehensive evaluation of the differential impacts of aerobic vs. anaerobic training on hematological indices and iron status among adolescent female athletes. The aim of this study was to assess the hematological factors and iron status in aerobic vs. anaerobic training in athletic females. Methods: This observational, cross-sectional study recruited twenty-five adolescent athletic females; thirteen of them participated in an aerobic sport (long-distance running), while twelve of them participated in an anaerobic sport (broad jumping). Hematological factors were assessed by analyzing blood concentrations of hemoglobin (Hb), hematocrit (Hct), red blood cell (RBC) count, mean corpuscular volume (MCV), and mean corpuscular hemoglobin concentration (MCHC), while the iron status assessment was conducted through evaluating levels of serum transferrin and serum ferritin. Results: Athletic females who participated in the aerobic sport showed significantly lower Hb (MD −0.84; 95% CI −1.63: −0.04; p = 0.041), Hct (MD −5.49; 95% CI −7.86: −3.12; p = 0.0001), RBC count (MD −0.37; 95% CI −0.57: −0.17; p = 0.001), and MCV (MD −5.15; 95% CI −9.41: −0.89; p = 0.020), as well as significantly higher MCHC (MD 2.99; 95% CI 2.18: 3.79; p = 0.0001) and serum transferrin (MD 46.77; 95% CI 10.95: 82.59; p = 0.013) than athletic females who participated in the anaerobic sport. However, there was an insignificant difference in serum ferritin levels (MD −3.18; 95% CI −11.49: 5.13; p = 0.437) between both groups. Conclusion: Except for the ferritin level that exhibited an insignificant difference between aerobic and anaerobic training, aerobic training was associated with a worse impact on the hematological factors and iron status than anaerobic training in adolescent athletic females. [ABSTRACT FROM AUTHOR]

Abstract Background Re-exploration of bleeding after cardiac surgery is associated with significant morbidity and mortality. Perioperative blood loss and rate of re-exploration are variable among centers and surgeons. Objective To present our experience of low rate of re-exploration based on adopting checklist for hemostasis and algorithm for management. Methods Retrospective analysis of medical records was conducted for 565 adult patients who underwent surgical treatment of congenital and acquired heart disease and were complicated by postoperative bleeding from Feb 2006 to May 2019. Demographics of patients, operative characteristics, perioperative risk factors, blood loss, requirements of blood transfusion, morbidity and mortality were recorded. Logistic regression was used to identify predictors of re-exploration and determinants of adverse outcome. Results Thirteen patients (1.14%) were reexplored for bleeding. An identifiable source of bleeding was found in 11 (84.6%) patients. Risk factors for re-exploration were high body mass index, high Euro SCORE, operative priority (urgent/emergent), elevated serum creatinine and low platelets count. Re-exploration was significantly associated with increased requirements of blood transfusion, adverse effects on cardiorespiratory state (low ejection fraction, increased s. lactate, and prolonged period of mechanical ventilation), longer intensive care unit stay, hospital stay, increased incidence of SWI, and higher mortality (15.4% versus 2.53% for non-reexplored patients). We managed 285 patients with severe or massive bleeding conservatively by hemostatic agents according to our protocol with no added risk of morbidity or mortality. Conclusion Low rate of re-exploration for bleeding can be achieved by strict preoperative preparation, intraoperative checklist for hemostasis implemented by senior surgeons and adopting an algorithm for management.

Abstract Background Muscle weakness is a widespread problem in children with Erb’s palsy as it can cause changes in muscle architecture parameters, which can be detected by ultrasonography. This study was conducted to determine the relation between age, muscle architecture, and muscle strength in children with Erb’s palsy. A total of 40 children with Erb’s palsy from both sexes aged 1–2.5 years were included in this study. Muscle thickness and pennation angle were measured by ultrasonography, and muscle strength was measured using the active movement scale. Results A significant relation was found between age, muscle thickness, pennation angle, and muscle strength (P < 0.05). Moreover, a significant difference was found in muscle architecture parameters during relaxation and contraction in both study groups and in each study group (P < 0.05). Conclusion Muscle weakness in children with Erb’s palsy has an effect on muscle architecture parameters, and these parameters also increase with age.

Abstract Background Pericardial patches are often used for repair of congenital cardiac defects. The aim of this study was to describe our initial experience with the use of equine pericardium and its safety and advantages and disadvantages compared to bovine pericardium. Methods We designed a retrospective cohort study of 111 patients who were surgically treated for congenital heart disease between 2017 and 2020. Equine pericardium was used in 58 patients and bovine pericardium was used in 53 patients. Recorded variables included demographic data, preoperative cardiac pathology, site of patch insertion, morbidity and mortality. Results The overall survival rate was 94.5% and no deaths were related to patch insertion. None of our patients were reoperated on for patch related complications. Postoperative transcatheter intervention was needed in 2 patients (1.8%): one for dilatation of aortic arch stenosis after repair of hypoplastic left heart syndrome with equine pericardium and one for dilatation of pulmonary artery branches after repair of tetralogy of Fallot using bovine pericardium. Conclusions Equine pericardium is a safe patch material for reconstruction in congenital heart surgery. It may be preferable to bovine pericardium in cases requiring a complex shape or a pliable patch as in in arch reconstruction or for valve reconstruction.

The coronavirus disease 2019 pandemic is an evolving pandemic caused by severe acute respiratory syndrome coronavirus 2. The disease was first recognized in Wuhan, China, in December 2019. It was announced as an International Public Health Emergency in January 2020, and as a pandemic in March 2020. By reaching October 2020, more than 34.6 million cases along with 1.02 million deaths have been declared worldwide. The virus is of zoonotic origin and spreads most often when people are in close contact via small droplets or via contaminated surfaces. Common symptoms are mostly fever and respiratory symptoms and might be complicated by pneumonia and ARDS. Preventive measures include hand hygiene, social distancing, wearing a face mask in public, and self-isolation for suspected cases. Authorities worldwide implemented travel restrictions, lockdowns, screening, and contact tracing to slow the spread of the disease. These policies led to global social and economic burden, and up to 100 million people have fallen into extreme poverty.

Congenital cardiac surgery is one of the most challenging and fascinating branches of modern medicine which continues to advance in areas and improving outcomes, post-operative and pre-operative care. Patent Ductus Arteriosus was the first congenital heart lesion to be successfully corrected surgically. The landmark surgery was performed by Dr. Robert E. Gross in 1938 and opened up the possibility of subsequent surgical correction of various other lesions, which were considered to be untreatable previously. The first successful surgical closure of persistent ductus arteriosus (PDA) was preceded by years of work and contributed by various surgeons, physicians, and anatomists, dating all the way back to the 1st century. They are all worthy of recognition and praise. This article covers the important events related to PDA lesions including its first identification, followed by its description in various texts and sources over the course of time, failed attempts at surgical correction, and disputes regarding credits. These contributions to the branch cannot be overstated and serves as an inspiration to cardiac surgeons all over the world and to students, interns, and newly graduated doctors as well, who would one day like to be part of this fascinating branch.

During the current COVID-19 pandemic, there are potential threats that could affect antimicrobial stewardship activities and drive antimicrobial resistance. For instance, many individuals presenting with mild disease without pneumonia or moderate disease with pneumonia receive antibiotics. Zhou et al. [5] showed that in the current coronavirus disease 2019 (COVID-19) pandemic, 50% of patients with COVID-19 who have died had secondary bacterial infections. Rapid characterization of coinfection is essential. It will save lives. Notably, among COVID-19 ICU cases in Zhongnan Hospital, there was a high reported frequency of secondary infections with carbapenem-resistant Acinetobacter baumannii, particularly among ICU deaths. The standard empiric antibacterial treatment should be initially prescribed for adults with clinical and radiographic evidence of CAP who test positive in the inpatient and outpatient settings. If hydroxychloroquine is being used for COVID-19 treatment, avoid antibiotics that also prolong QTc interval (e.g. levofloxacin, azithromycin).

Abstract Objectives Persistent truncus arteriosus represents less than 3% of all congenital heart defects. We aim to analyze mid-term outcomes after primary Truncus arteriosus repair at different ages and to identify the risk factors contributing to mortality and the need for intervention after surgical repair. Methods This retrospective cohort study included 36 children, underwent repair of Truncus arteriosus in the period from January 2011 to December 2018 in two institutions. We recorded the clinical and echocardiographic data for the patients preoperatively, early postoperative, 6 months postoperative, then every year until their last documented follow-up appointment. Results Thirty-six patients had truncus arteriosus repair during the study period. Thirty-one patients had open sternum post-repair, and two patients required extracorporeal membrane oxygenation. Bleeding occurred in 15 patients (41.67%), and operative mortality occurred in 5 patients (14.7%). Patients with truncus arteriosus type 2 (p = 0.008) and 3 (p = 0.001) and who were ventilated preoperatively (p

Copyright of Shedet is the property of Shedet and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

With 755 million tonnes consumed as a cereal grain in 2020, rice is the most consumed crop in the world. Estimating rice's water requirements is crucial since the crop often grows under flood conditions and water serves a number of vital purposes for it. This study uses the Penman-Monteith (FAO 56-PM) method to assess and estimate evapotranspiration, whereas the METRIC model is used to calculate surface enrage balance. The estimation and monitoring of field agricultural water use has shown to be a successful application of remote sensing technology. Using remote sensing techniques, this work aimed to develop a method for estimating crop coefficient and actual crop evapotranspiration (ETc). for rice using METRIC model within the Google Earth Engine (GEE) based on Landsat-8 satellite imagery. The average seasonal ETo (FAO56) resulted 469 mm for crop rice and the water productivity (WP) was 0.42 kg m-3. Good correlations were found between the crop coefficients (Kc) proposed by FAO and (Kc) sat, with R2 0.92. The KcFAO used to validate KcSat. Linear relationship between KcFAO and KcSat was established and R2 was 0.96. Normalized Deference Vegetation Index (NDVI) used to estimate crop coefficient according to satellite data (KcSat). Landsat TM and Landsat ETM+ data were used to outline the growth of vegetation cover, and these data were coupled with land surface temperature (LST) taken from Landsat8 satellite data and air temperature (Tair) acquired from ground stations. The findings indicated that as cultivated area expanded during rice development, (LST) declined by around 2.3°C and (Tair) reduced by roughly 1.6°C. [ABSTRACT FROM AUTHOR]

Pulmonary hypertension is commonly associated with heart failure with preserved ejection fraction. In heart failure with preserved ejection fraction, the elevated left-sided filling pressures result in isolated post-capillary pulmonary hypertension or combined pre- and post-capillary pulmonary hypertension. Although right heart catheterization is the gold standard for diagnosis, it is an invasive test with associated risks. The ability of sub-maximum cardiopulmonary exercise test as an adjunct diagnostic tool in pulmonary hypertension-associated heart failure with preserved ejection fraction is not known. Forty-six patients with heart failure with preserved ejection fraction and pulmonary hypertension (27 patients with combined pre- and post-capillary pulmonary hypertension and 19 patients with isolated post-capillary pulmonary hypertension) underwent sub-maximum cardiopulmonary exercise test followed by right heart catheterization. The study also included 18 age- and gender-matched control subjects. Several sub-maximum gas exchange parameters were examined to determine the ability of sub-maximum cardiopulmonary exercise test to distinguish between isolated post-capillary pulmonary hypertension and combined pre- and post-capillary pulmonary hypertension. Conventional echocardiogram measures did not distinguish between isolated post-capillary pulmonary hypertension and combined pre- and post-capillary pulmonary hypertension. Compared to isolated post-capillary pulmonary hypertension, combined pre- and post-capillary pulmonary hypertension had greater ventilatory equivalent for carbon dioxide (VE/VCO 2 ) slope, reduced delta end-tidal CO 2 change during exercise, reduced oxygen uptake efficiency slope, and reduced gas exchange determined pulmonary vascular capacitance. The latter was significantly associated with right heart catheterization determined pulmonary artery compliance ( r = 0.5; p = 0.0004). On univariate analysis, sub-maximum VE/VCO 2 , delta end-tidal carbon dioxide, and gas exchange determined pulmonary vascular capacitance emerged as independent predictors of the extrapolated maximum oxygen uptake (%predicted) (β-coefficient values of –7.32, 95% CI: –13.3 – (–1.32), p = 0.01; 8.01, 95% CI: 1.96–14.05, p = 0.01; 8.78, 95% CI: 2.26–15.29, p = 0.01, respectively). Sub-maximum gas exchange parameters obtained during cardiopulmonary exercise test in an ambulatory setting allows for discrimination between isolated post-capillary pulmonary hypertension and combined pre- and post-capillary pulmonary hypertension. Additionally, sub-maximum cardiopulmonary exercise test derived VE/VCO 2 , delta end-tidal carbon dioxide, and gas exchange determined pulmonary vascular capacitance influences aerobic capacity in heart failure with preserved ejection fraction.