Effects of long‐term endurance and resistance training on diastolic function, exercise capacity, and quality of life in asymptomatic diastolic dysfunction vs. heart failure with preserved ejection fraction

ESC Heart Failure

Kathleen Nolte⁶  Silja Schwarz³  Götz Gelbrich⁵  Steffen Mensching³  Friederike Siegmund³  Rolf Wachter⁶  Gerd Hasenfuss⁶  Hans-Dirk Düngen²  Christoph Herrmann-Lingen⁴  Martin Halle³  Burkert Pieske¹ 

[1] Department of Cardiology, Medical University of Graz, Graz, Austria;Campus Virchow-Klinikum, Department of Cardiology, Charité-Universitätsmedizin, Berlin, Germany;Department of Prevention, Rehabilitation and Sports Medicine, Munich & German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Technische Universität München, Munich, Germany;German Center for Cardiovascular Research Site Göttingen, DZHK, Berlin, Germany;Institute for Epidemiology and Biometry, University of Würzburg, Würzburg, Germany;Department of Cardiology, University of Göttingen, Göttingen, Germany

关键词: Diastolic dysfunction;    Heart failure with preserved ejection fraction;    Exercise training;   

DOI  :  10.1002/ehf2.12007

来源: Wiley

【 摘 要 】

ABSTRACT

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

Patients were 62 ± 8 years old (37% female). In the HFpEF group, 67% of patients were in NYHA class II (33% in NYHA III). Exercise capacity (peak oxygen consumption, peak VO₂) differed at baseline (DD 29.2 ± 8.7 mL/min/kg vs. HFpEF 17.8 ± 4.6 mL/min/kg; P = 0.004). After 6 months, peak VO₂ 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.

【 授权许可】

CC BY-NC-ND   
© 2014 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.