Document Detail

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.
MedLine Citation:
PMID:  21996391     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to determine whether structured exercise training (ET) improves maximal exercise capacity, left ventricular diastolic function, and quality of life (QoL) in patients with heart failure with preserved ejection fraction (HFpEF).
BACKGROUND: Nearly one-half of patients with heart failure experience HFpEF, but effective therapeutic strategies are sparse.
METHODS: A total of 64 patients (age 65 ± 7 years, 56% female) with HFpEF were prospectively randomized (2:1) to supervised endurance/resistance training in addition to usual care (ET, n = 44) or to usual care alone (UC) (n = 20). The primary endpoint was the change in peak Vo(2) after 3 months. Secondary endpoints included effects on cardiac structure, diastolic function, and QoL.
RESULTS: Peak Vo(2) increased (16.1 ± 4.9 ml/min/kg to 18.7 ± 5.4 ml/min/kg; p < 0.001) with ET and remained unchanged (16.7 ± 4.7 ml/min/kg to 16.0 ± 6.0 ml/min/kg; p = NS) with UC. The mean benefit of ET was 3.3 ml/min/kg (95% confidence interval [CI]: 1.8 to 4.8, p < 0.001). E/e' (mean difference of changes: -3.2, 95% CI: -4.3 to -2.1, p < 0.001) and left atrial volume index (milliliters per square meter) decreased with ET and remained unchanged with UC (-4.0, 95% CI: -5.9 to -2.2, p < 0.001). The physical functioning score (36-Item Short-Form Health Survey) improved with ET and remained unchanged with UC (15, 95% CI: 7 to 24, p < 0.001). The ET-induced decrease of E/e' was associated with 38% gain in peak Vo(2) and 50% of the improvement in physical functioning score.
CONCLUSIONS: Exercise training improves exercise capacity and physical dimensions of QoL in HFpEF. This benefit is associated with atrial reverse remodeling and improved left ventricular diastolic function. (Exercise Training in Diastolic Heart Failure-Pilot Study: A Prospective, Randomised, Controlled Study to Determine the Effects of Physical Training on Exercise Capacity and Quality of Life [Ex-DHF-P]; ISRCTN42524037).
Frank Edelmann; Götz Gelbrich; Hans-Dirk Düngen; Stefan Fröhling; Rolf Wachter; Raoul Stahrenberg; Lutz Binder; Agnieszka Töpper; Diana Jahandar Lashki; Silja Schwarz; Christoph Herrmann-Lingen; Markus Löffler; Gerd Hasenfuss; Martin Halle; Burkert Pieske
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  58     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-14     Completed Date:  2011-12-07     Revised Date:  2012-06-07    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1780-91     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Department of Cardiology, University of Göttingen, Göttingen, Germany.
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MeSH Terms
Exercise Tolerance
Heart Failure, Diastolic / therapy*
Heart Function Tests
Middle Aged
Pilot Projects
Prospective Studies
Quality of Life
Resistance Training*
Comment In:
J Am Coll Cardiol. 2012 May 1;59(18):1658; author reply 1658-9   [PMID:  22538339 ]
J Am Coll Cardiol. 2011 Oct 18;58(17):1792-4   [PMID:  21996392 ]

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