Exercise training response (ΔV˙O2peak) in systolic heart failure correlated negatively with age, LVEF, and NYHA class, with NYHA class II predicting higher response vs class III (OR 7.1; P=0.002).
RCT (n=215)
randomized
What are the baseline and exercise predictors of change in peak oxygen uptake in patients with systolic heart failure undergoing exercise training?
In patients with systolic heart failure, younger age, higher LVEF, lower NYHA class, and the ability to increase workload during training predict a better improvement in peak oxygen uptake following exercise interventions.
Effect estimate: OR 7.1 (95% CI 2.0-24.9)
p-value: p=0.002
PURPOSE: This study aimed to investigate baseline, exercise testing, and exercise training-mediated predictors of change in peak oxygen uptake (V˙O2peak) from baseline to 12-wk follow-up (ΔV˙O2peak) in a post hoc analysis from the SMARTEX Heart Failure trial. METHODS: We studied 215 patients with heart failure with left ventricular ejection fraction (LVEF) ≤35%, and New York Heart Association (NYHA) classes II-III who were randomized to either supervised high-intensity interval training with exercise target intensity of 90%-95% of peak heart rate (HRpeak) or supervised moderate continuous training (MCT) with target intensity of 60%-70% of HRpeak, or who received a recommendation of regular exercise on their own. Predictors of ΔV˙O2peak were assessed in two models: a logistic regression model comparing highest and lowest tertiles (baseline parameters) and a multivariate linear regression model (test/training/clinical parameters). RESULTS: The change in V˙O2peak in response to the interventions (ΔV˙O2peak) varied substantially, from -8.50 to +11.30 mL·kg·min. Baseline NYHA (class II gave higher odds vs III; odds ratio (OR), 7.1 (2.0-24.9); P = 0.002), LVEF (OR per percent, 1.1 (1.0-1.2); P = 0.005), and age (OR per 10 yr, 0.5 (0.3-0.8); P = 0.003) were associated with ΔV˙O2peak.In the multivariate linear regression, 34% of the variability in ΔV˙O2peak was explained by the increase in exercise training workload, ΔHRpeak between baseline and 12-wk posttesting, age, and ever having smoked. CONCLUSION: Exercise training response (ΔV˙O2peak) correlated negatively with age, LVEF, and NYHA class. The ability to increase workload during the training period and increased ΔHRpeak between baseline and the 12-wk test were associated with a positive outcome.
Karlsen et al. (Mon,) conducted a rct in Systolic Heart Failure (n=215). Supervised high-intensity interval training vs. Supervised moderate continuous training or regular exercise was evaluated on Change in peak oxygen uptake (V˙O2peak) from baseline to 12-wk follow-up (OR 7.1, 95% CI 2.0-24.9, p=0.002). Exercise training response (ΔV˙O2peak) in systolic heart failure correlated negatively with age, LVEF, and NYHA class, with NYHA class II predicting higher response vs class III (OR 7.1; P=0.002).