Key result
Physical inactivity drives cardiac atrophy and blunted reserve, marking exercise deficiency a key HFpEF risk factor.
Why the study?
There is a need to understand the role of physical activity and exercise deficiency as a major risk factor and phenotype component in heart failure with preserved ejection fraction.
Does physical inactivity increase the risk of developing heart failure with preserved ejection fraction?
Does physical inactivity increase the risk of developing heart failure with preserved ejection fraction?
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“There is no other tool in our armamentarium as physicians that is so broadly beneficial to so many people.”
“Exercise doesn't only change your physical appearance; it also impacts and changes virtually every aspect of our cardiovascular system. It's vital that cardiologists and the wider population understand just how important exercise is to our heart health and how much we should be doing if we want to live long and healthy lives.”
“Given the mounting interest in sports cardiology, its key relevance to all cardiovascular practitioners, and the knowledge explosion in this field, we felt it was particularly timely to pay special attention to this broad topic with a JACC Focus Seminar series.”
This review frames HFpEF as partly an exercise deficiency syndrome, suggesting that lifelong physical activity is critical to preventing age-related cardiac stiffening and atrophy.
Across differing spectrums of cardiac function and cardiac pathologies, there are strong associations between measures of cardiorespiratory fitness and burden of symptoms, quality of life, and prognosis. In this part 2 of a 4-part series, we contend that there is a strong association among physical activity, cardiorespiratory fitness, and cardiac function. We argue that a chronic lack of exercise is a major risk factor for heart failure with preserved ejection fraction in some patients. In support of this hypothesis, increasing physical activity is associated with greater cardiac mass, greater stroke volumes, greater cardiac output and peak oxygen consumption, and fewer clinical events. Conversely, physical inactivity results in cardiac atrophy, reduced output, reduced chamber size, and decreased ability to augment cardiac performance with exercise. Moreover, physical inactivity is a strong predictor of heart failure risk and death. In sum, exercise deficiency should be considered part of the broad heart failure with preserved ejection fraction phenotype.
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Gerche et al. (2022) conducted a review in Heart Failure with Preserved Ejection Fraction (HFpEF). Physical inactivity vs. Physical activity was evaluated. Physical inactivity results in cardiac atrophy, reduced cardiac output, and decreased reserve, making exercise deficiency a major risk factor for heart failure with preserved ejection fraction.
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