Exercise Training and Heart Failure with Preserved Ejection Fraction: What the Evidence of the Studies Show?
Federal University of Uberlândia, Department of Clinical Research, Brazil
- *Corresponding Author:
- Leonardo Roever
Department of Clinical Research
Av. Pará, 1720 - Bairro Umuarama
Uberlândia MG CEP 38400-902, Brazil
E-mail: [email protected]
Received Date: October 22, 2015; Accepted Date: October 23, 2015; Published Date: November 09, 2015
Citation: Roever L (2015) Exercise Training and Heart Failure with Preserved Ejection Fraction: What the Evidence of the Studies Show?. Transl Med 5:e134. doi:10.4172/2161-1025.1000e134
Copyright: © 2015 Roever L. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Visit for more related articles at Translational Medicine
Exercise intolerance is a common symptom in patients with heart failure with preserved ejection fraction (HFpEF). HFpEF is characterized through the lack of proven effective therapies. Exercise training (ET) is associated with improved exercise tolerance among sedentary, metabolic syndrome, diabetes, obese, and hypertensive participants who are at high risk for HFpEF [1-8].
Pandey and colleagues reported a study to evaluate the efficacy of exercise training in patients with HFPEF in a meta-analysis. Primary outcome of the study was change in cardiorespiratory fitness (CRF), measured as change in peak oxygen uptake. Effect of ET on quality of life, and left ventricular systolic and diastolic function was also assessed. The authors included 276 patients who were enrolled in 6 randomized controlled trials. Patients with HFpEF undergoing ET had significantly improved CRF (mL/kg per min; weighted mean difference, 2.72; 95% CI, 1.79-3.65) and quality of life (weighted mean difference, -3.97; 95% CI, -7.21 to -0.72) when compared with the control group. No significant change was observed in the systolic function (EF-weighted mean difference, 1.26; 95% CI, -0.13% to 2.66%) or diastolic function (E/A-weighted mean difference, 0.08; 95% CI, -0.01 to 0.16) with exercise training in patients with HFpEF .
ET in patients with HFpEF is associated with an improvement in CRF and quality of life without significant changes in left ventricular systolic or diastolic function. Adherence methods of the ET program should be implemented in this population towards a lower morbidity and mortality.
- Kitzman DW, Little WC, Brubaker PH, Anderson RT, Hundley WG, et al., (2002) Pathophysiological characterization of isolated diastolic heart failure in comparison to systolic heart failure. JAMA 288: 2144-2150.
- Church TS, Earnest CP, Skinner JS, Blair SN (2007) Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial. JAMA 297: 2081-2091.
- Gary RA, Sueta CA, Dougherty M, Rosenberg B, Cheek D, et al., (2004) Home-based exercise improves functional performance and quality of life in women with diastolic heart failure. Heart Lung 33: 210-218.
- Kitzman DW, Brubaker PH, Morgan TM, Stewart KP, Little WC (2010) Exercise training in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial. Circ Heart Fail 3: 659-667.
- Edelmann F, Gelbrich G, Düngen HD, Fröhling S, Wachter R, et. al., (2011) Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study. J Am Coll Cardiol 58: 1780-1791.
- Alves AJ, Ribeiro F, Goldhammer E, Rivlin Y, Rosenschein U, et al., (2012) Exercise training improves diastolic function in heart failure patients. Med Sci Sports Exerc 44: 776-785.
- Smart NA, Haluska B, Jeffriess L, Leung D (2012) Exercise training in heart failure with preserved systolic function: a randomized controlled trial of the effects on cardiac function and functional capacity. Congest Heart Fail 18: 295-301.
- Kitzman DW, Brubaker PH, Herrington DM, Morgan TM, Stewart KP, et al., (2013) Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial. J Am Coll Cardiol 62: 584-592.
- Pandey A, Parashar A, Kumbhani DJ, Agarwal S,Garg J, et al., (2015) Exercise training in patients with heart failure and preserved ejection fraction: meta-analysis of randomized control trials. Circ Heart Fail 8: 33-40.