Ex-DHF: Exercise training improves exercise capacity, diastolic function in HF patients

Edelmann F. J Am Coll Cardiol. 2011;58:1780-1791.

Issue: December 2011

Exercise training in patients with HF and preserved ejection fraction improved functional capacity, diastolic function and overall quality of life, according to results of a study.

Researchers from the Exercise training in Diastolic Heart Failure (Ex-DHF) pilot study randomly assigned 64 patients (mean age, 65 years; 56% women) with HF with preserved ejection fraction in a 2:1 ratio to usual care (n=20) or supervised endurance/resistance training along with usual care (n=44). The usual-care group was instructed to maintain typical daily activities, whereas the exercise-training group participated in endurance and resistance training. The primary endpoint was change in peak oxygen consumption after 3 months; cardiac structure, diastolic function and quality of life were secondary endpoints.

Overall, the mean benefit of exercise training on peak oxygen consumption was 3.3 mL/min/kg (95% CI, 1.8-4.8). Patients in the exercise-training group had a greater increase in peak oxygen consumption (16.1 ± 4.9 mL/min/kg to 18.7 ± 5.4 mL/min/kg; P<.001) and improved physical functioning score vs. patients in the usual-care group, whose oxygen consumption (16.7 ± 4.7 mL/min/kg to 16 ± 6 mL/min/kg) and physical functioning remained unchanged.

Similarly, the E/e’ ratio and left atrial volume index did not change in the usual-care group but decreased in the exercise-training group (–4; 95% CI, –5.9 to –2.2). This decrease in E/e’ was “associated with 38% gain in peak oxygen consumption and 50% of the improvement in physical functioning score,” according to study results.

Researchers also noted improvement in NYHA functional class among the exercise training group (P=.009 vs. controls).

Disclosure: The researchers report no relevant financial disclosures.

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