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Role of Physical Training in Heart Failure with Preserved Ejection Fraction

  • Pathophysiology: Neuroendocrine, Vascular, and Metabolic Factors (SD Katz, Section editor)
  • Published:
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Abstract

About 50 % or more of heart failure (HF) patients living in the community have preserved left ventricular ejection fraction (HFpEF), and the proportion is higher among women and the very elderly. A cardinal feature of HFpEF is reduced aerobic capacity, measured objectively as peak exercise pulmonary oxygen uptake (peak VO2), that results in decreased quality of life. Specifically, peak VO2 of HFpEF patients is 30–70 % lower than age-, sex-, and comorbidity-matched control patients without HF. The mechanisms for the reduced peak VO2 are due to cardiovascular and skeletal muscle dysfunction that results in reduced oxygen delivery to and/or utilization by the active muscles. Currently, four randomized controlled exercise intervention trials have been performed in HFpEF patients. These studies have consistently demonstrated that 3–6 months of aerobic training performed alone or in combination with strength training is a safe and effective therapy to increase aerobic capacity and endurance and quality of life in HFpEF patients. Despite these benefits, the physiologic mechanisms underpinning the improvement in peak exercise performance have not been studied; therefore, future studies are required to determine the role of physical training to reverse the impaired cardiovascular and skeletal muscle function in HFpEF patients.

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Acknowledgements

Dr. Mark Haykowsky is the exercise physiology section leader for the Alberta Heart Study funded by Alberta Heritage Foundation for Medical Research (Alberta Innovates). This work was also supported in part by NIH Grants R37AG18915 and P30AG21332.

Disclosures

M. Haykowsky: none; P. Brubaker: none. Dr. Dalane Kitzman has served as a consultant for Boston Scientific, Abbott Laboratories, and Relypsa Inc.; has received grants from Novartis; and hold stock interest in Relypsa, Inc. and Gilead.

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Authors and Affiliations

  1. Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, T6G 2 G4, Canada

    Mark Haykowsky

  2. Department of Health and Exercise Sciences, Wake Forest University, PO Box 7868, Winston-Salem, NC, 27109, USA

    Peter Brubaker

  3. Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Dalane Kitzman

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  1. Mark Haykowsky
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  2. Peter Brubaker
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  3. Dalane Kitzman
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Correspondence to Mark Haykowsky.

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Haykowsky, M., Brubaker, P. & Kitzman, D. Role of Physical Training in Heart Failure with Preserved Ejection Fraction. Curr Heart Fail Rep 9, 101–106 (2012). https://doi.org/10.1007/s11897-012-0087-7

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  • DOI: https://doi.org/10.1007/s11897-012-0087-7

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