Document Detail

Cardiovascular effects of 1 year of progressive endurance exercise training in patients with heart failure with preserved ejection fraction.
MedLine Citation:
PMID:  23194487     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a disease of the elderly with cardiovascular stiffening and reduced exercise capacity. Exercise training appears to improve exercise capacity and cardiovascular function in heart failure with reduced ejection fraction. However, it is unclear whether exercise training could improve cardiovascular stiffness, exercise capacity, and ventricular-arterial coupling in HFpEF.
METHODS: Eleven HFpEF patients and 13 healthy controls underwent invasive measurements with right heart catheterization to define Starling and left ventricular (LV) pressure-volume curves; secondary functional outcomes included Doppler echocardiography, arterial stiffness, cardiopulmonary exercise testing with cardiac output measurement, and ventricular-arterial coupling assessed by the dynamic Starling mechanism. Seven of 11 HFpEF patients (74.9 ± 6 years; 3 men/4 women) completed 1 year of endurance training followed by repeat measurements. Pulmonary capillary wedge pressures and LV end-diastolic volumes were measured at baseline during decreased and increased cardiac filling. LV compliance was assessed by the slope of the pressure-volume curve. Beat-to-beat LV end-diastolic pressure (estimated from pulmonary arterial diastolic pressure) and stroke volume index were obtained, and spectral transfer function analysis was used to assess the dynamic Starling mechanism.
RESULTS: Before training, HFpEF patients had reduced exercise capacity, distensibility and dynamic Starling mechanism but similar LV compliance and end-diastolic volumes compared to controls albeit with elevated filling pressure and increased wall stress. One year of training had little effect on LV compliance and volumes, arterial stiffness, exercise capacity or ventricular-arterial coupling.
CONCLUSION: Contrary to our hypothesis, 1 year of endurance training failed to impart favorable effects on cardiovascular stiffness or function in HFpEF.
Naoki Fujimoto; Anand Prasad; Jeffrey L Hastings; Paul S Bhella; Shigeki Shibata; Dean Palmer; Benjamin D Levine
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Publication Detail:
Type:  Journal Article     Date:  2012-10-29
Journal Detail:
Title:  American heart journal     Volume:  164     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-30     Completed Date:  2013-02-12     Revised Date:  2013-12-04    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  869-77     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
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MeSH Terms
Aged, 80 and over
Case-Control Studies
Echocardiography, Doppler
Exercise Test
Exercise Therapy*
Exercise Tolerance / physiology
Heart Failure / physiopathology,  therapy*
Stroke Volume / physiology*
Treatment Outcome
Vascular Stiffness
Ventricular Function, Left / physiology
Grant Support
Comment In:
Am Heart J. 2012 Dec;164(6):807-9   [PMID:  23194479 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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