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

2011 | journal article; research paper. A publication with affiliation to the University of Göttingen.

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​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​
Edelmann, F. ; Gelbrich, G.; Duengen, H.-D.; Froehling, S.; Wachter, R. ; Stahrenberg, R. & Binder, L.  et al.​ (2011) 
Journal of the American College of Cardiology58(17) pp. 1780​-1791​.​ DOI: https://doi.org/10.1016/j.jacc.2011.06.054 

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Authors
Edelmann, Frank ; Gelbrich, Götz; Duengen, Hans-Dirk; Froehling, Stefan; Wachter, Rolf ; Stahrenberg, Raoul; Binder, Lutz ; Toepper, Agnieszka; Lashki, Diana Jahandar; Schwarz, Silja; Herrmann-Lingen, Christoph ; Loeffler, Markus; Hasenfuß, Gerd ; Halle, Martin; Pieske, Burkert 
Abstract
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 V(O2) after 3 months. Secondary endpoints included effects on cardiac structure, diastolic function, and QoL. Results Peak V(O2) increased (16.1 +/- 4.9 ml/min/kg to 18.7 +/- 5.4ml/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 V(O2) 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) (J Am Coll Cardiol 2011;58: 1780-91) (C) 2011 by the American College of Cardiology Foundation
Issue Date
2011
Publisher
Elsevier Science Inc
Journal
Journal of the American College of Cardiology 
ISSN
0735-1097

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