A 6-month endurance and resistance training program improved E/e' ratio in HFpEF (12.2 to 10.1, P<0.002) and asymptomatic DD (10.7 to 9.5, P=0.03), with no significant difference between groups.
Does combined endurance and resistance training improve exercise capacity, diastolic function, and quality of life in patients with asymptomatic diastolic dysfunction or HFpEF?
A 6-month structured exercise training program effectively improves exercise capacity and diastolic function in patients with both asymptomatic diastolic dysfunction and overt HFpEF.
BACKGROUND: The long-term effects of exercise training (ET) in diastolic dysfunction (DD) and heart failure with preserved ejection fraction (HFpEF) are unknown. The present study compared the long-term effects of ET on exercise capacity, diastolic function, and quality of life (QoL) in patients with DD vs. HFpEF. METHODS: A total of n = 43 patients with asymptomatic DD (n = 19) or HFpEF DD and New York Heart Association (NYHA) ≥II, n = 24 and left ventricular ejection fraction ≥50% performed a combined endurance/resistance training over 6 months (2-3/week) on top of usual care. Cardiopulmonary exercise testing, echocardiography, and QoL were obtained at baseline and follow-up. RESULTS: increased significantly (P < 0.044) to 19.7 ± 5.8 mL/min/kg in the HFpEF group and also in the DD group (to 32.8 ± 8.5 mL/min/kg; P < 0.002) with no overall difference between the groups (P = 0.217). E/e' ratio (left ventricular filling index) decreased from 12.2 ± 3.5 to 10.1 ± 3.0 (P < 0.002) in patients with HFpEF and also in patients with DD (10.7 ± 3.1 vs. 9.5 ± 2.3; P = 0.03; difference between groups P = 0.210). In contrast, left atrial volume index decreased in the HFpEF group (P < 0.001) but remained stable within the DD group (difference between groups P = 0.015). After 6 months, physical QoL (Minnesota living with heart failure Questionnaire, 36-item short form health survey), general health perception, and 9-item patient health questionnaire score only improved in HFpEF (P < 0.05). In contrast, vitality improved in both groups (difference between groups P = 0.708). CONCLUSION: A structured 6 months ET programme effectively improves exercise capacity and diastolic function in patients with DD and overt HFpEF. Therefore, controlled lifestyle modification with physical activity is effective both in DD and HFpEF.
Nolte et al. (Mon,) conducted a other in Asymptomatic diastolic dysfunction vs. Heart failure with preserved ejection fraction (n=43). Combined endurance and resistance training vs. Asymptomatic DD vs. HFpEF was evaluated on Exercise capacity and diastolic function. A 6-month endurance and resistance training program improved E/e' ratio in HFpEF (12.2 to 10.1, P<0.002) and asymptomatic DD (10.7 to 9.5, P=0.03), with no significant difference between groups.