December 19, 2017
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Exercise confers benefit in HFpEF

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Higher amounts of physical activity increased physical function of quality of life and submaximal exercise capacity in patients with HF with preserved ejection fraction, according to a study published in ESC Heart Failure.

“Recommendations on the intensity of [physical activity] to prevent HFpEF and to improve QOL do not exist so far,” Anna Bobenko, MD, of the department of cardiology at Charité at Universitätsmedizin Berlin and the German Centre for Cardiovascular Research in Berlin, and colleagues wrote. “Our study shows a clear dose dependency of high-intensity [physical activity] and physical dimensions of QOL in HFpEF, which was not found for total amount of [physical activity].”

Researchers analyzed data from 422 patients (mean age, 67 years; 52% women) from the Aldo-DHF trial with stable chronic HF, evidence of diastolic dysfunction and preserved left ventricular ejection fraction of 50% or greater.

Six-minute walk test and cardiopulmonary exercise testing were used to assess exercise performance, whereas physical activity and quality of life with physical function were evaluated using the SF-36 questionnaire and a self-report questionnaire. Echocardiography was used to measure diastolic function.

Patients were categorized by weekly metabolic equivalents of task hours: low (< 70 hours), middle (70-140 hours) and high (> 140 hours).

Physical function of quality of life (r = 0.1; P = .05) and 6-minute walk test (r = 0.17; P = .001) were associated with total physical activity. The link was not seen in peak oxygen uptake.

The amount of time patients performed high-intensity physical activity was associated with peak oxygen uptake (r = 0.13; P = .01), 6-minute walk test distance (r =0.21; P < .001) and physical function (r = 0.13; P = .01), although this was not evident in low-intensity physical activity.

The amount and type of physical activity was not linked to measures of diastolic function.

“To improve maximal exercise capacity in HFpEF, high-intensity training in daily life should be compared with lower intensity of the same volume in future randomized exercise intervention trials in order to determine the optimal dose in primary and secondary preventions of HFpEF,” Bobenko and colleagues wrote. – by Darlene Dobkowski

Disclosure: The authors report no relevant financial disclosures.