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Effects of Exercise on Heart Failure with Preserved Ejection Fraction: An Updated Review of Literature

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journal contribution
posted on 2023-06-16, 15:18 authored by Giulia Crisci, Mariarosaria De Luca, Roberta D'Assante, Brigida Ranieri, Anna D'Agostino, Valeria Valente, Federica Giardino, Valentina Capone, Salvatore Chianese, Salvatore Rega, Rosangela Cocchia, Muhammad Zubair Israr, Radek Debiek, Liam M Heaney, Andrea Salzano
Heart failure with preserved ejection fraction (HFpEF) represents the most common HF phenotype of patients aged > 65 years, with an incidence and a prevalence that are constantly growing. The HFpEF cardinal symptom is exercise intolerance (EI), defined as the impaired ability to perform physical activity and to reach the predicted age-related level of exercise duration in the absence of symptoms—such as fatigue or dyspnea—and is associated with a poor quality of life, a higher number of hospitalizations, and poor outcomes. The evidence of the protective effect between exercise and adverse cardiovascular outcomes is numerous and long-established. Regular exercise is known to reduce cardiovascular events and overall mortality both in apparently healthy individuals and in patients with established cardiovascular disease, representing a cornerstone in the prevention and treatment of many cardio-metabolic conditions. Several studies have investigated the role of exercise in HFpEF patients. The present review aims to dwell upon the effects of exercise on HFpEF. For this purpose, the relevant data from a literature search (PubMed, EMBASE, and Medline) were reviewed. The analysis of these studies underlines the fact that exercise training programs improve the cardiorespiratory performance of HFpEF patients in terms of the increase in peak oxygen uptake, the 6 min walk test distance, and the ventilatory threshold; on the other hand, diastolic or systolic functions are generally unchanged or only partially modified by exercise, suggesting that multiple mechanisms contribute to the improvement of exercise tolerance in HFpEF patients. In conclusion, considering that exercise training programs are able to improve the cardiorespiratory performance of HFpEF patients, the prescription of exercise training programs should be encouraged in stable HFpEF patients, and further research is needed to better elucidate the pathophysiological mechanisms underpinning the beneficial effects described.

Funding

Dr Valentina Capone receives a research grant support from CardioPath, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.

History

Citation

Crisci, G.; De Luca, M.; D’Assante, R.; Ranieri, B.; D’Agostino, A.; Valente, V.; Giardino, F.; Capone, V.; Chianese, S.; Rega, S.; et al. Effects of Exercise on Heart Failure with Preserved Ejection Fraction: An Updated Review of Literature. J. Cardiovasc. Dev. Dis. 2022, 9, 241. https://doi.org/ 10.3390/jcdd9080241

Author affiliation

Department of Cardiovascular Sciences

Version

  • VoR (Version of Record)

Published in

JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE

Volume

9

Issue

8

Pagination

241

Publisher

MDPI

issn

2308-3425

eissn

2308-3425

Acceptance date

2023-07-20

Copyright date

2022

Available date

2023-06-16

Language

English