Effect of Aerobic Exercise on Peak Oxygen Consumption, VE/VCO2 Slope, and Health-Related Quality of Life in Patients with Heart Failure with Preserved Left Ventricular Ejection Fraction: a Systematic Review and Meta-Analysis

Gomes‐Neto, Mansueto; Durães, André Rodrigues; Conceição, Lino Sérgio Rocha; Roever, Leonardo; Liu, Tong; Tse, Gary; Biondi‐Zoccai, Giuseppe; Góes, Ana Lúcia Barbosa; Alves, Iura Gonzalez Nogueira; Ellingsen, Øyvind; Carvalho, Vitor Oliveira

doi:10.1007/s11883-019-0806-6

Cited by 21 publications

(24 citation statements)

References 37 publications

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“…Our present study showed a significant improvement of VO 2peak and nonslight improvement of VE / VCO 2 with no significant changes at the end of the 4week intervention. In agreement with our findings, a previous study demonstrated that aerobic exercise training improves functional capacity and has a positive prognosis in HF patients [30], and recent systematic review found no significant changes in VE / VCO 2 [31], while prior studies proved that high intensity exercise training may improve VE / VCO 2 in HF patients [32,33]. We observed a slight decrease of VE / VCO 2 regarding the beneficial effects of regular aerobic exercise in the improvement of ventilatory efficiency in HF patients.…”

Section: Resultssupporting

confidence: 93%

Sleep quality and ventilatory efficiency in elderly heart failure patients: a pilot study on the short-term effect of 4-week low-intensity aerobic exercise

Abdelbasset

Osailan

2020

Kardiologiia

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Background Sleep disturbance and ventilator inefficiency are considered two of the most critical complications for general human wellbeing, particularly in elderly heart failure (HF) patients. Studies examining the effect of low-intensity aerobic exercise in the treatment of sleep disturbance and ventilatory inefficiency in this population of patients are limited.Objective The purpose of the current pilot study was to check the effect of low-intensity aerobic exercise on the quality of sleep and ventilatory efficiency in elderly HF patients.Materials and methods Design: pilot study. Setting: outpatient physical therapy clinic within Cairo University regional hospital. Participants: eight elderly HF patients (6 men, 2 women) with a mean age of 69.4±4.2 years. Intervention: participants were recruited for a low-intensity exercise program (40 to 50% of maximum heart rate for 30-40 minutes), five sessions weekly for four weeks. Exercise intensity was monitored during the sessions using heart rate. Outcome Measure: sleep quality was assessed pre- and post- four weeks of exercise program usingthe Pittsburgh sleep quality index (PSQI) and ventilatory efficiency was assessed using cardiopulmonary exercise test.Results HF patients (II–III NYHA), mean age 69.4±4.2 years, body mass index 23.7±2.7 kg/m2, ejection fraction 32.7±4.5 %, VO2peak 16.27±4.2 ml/kg/min, VE/VCO2 30.81±12.7. The mean of global PSQI score ranged between 8.2 to 11.4 with a mean of 9.7±3.4 which indicates that the participants experienced sleep disturbance. The post-exercise assessment showed that patients have reported a significant improvement of all PSQI domains compared with baseline assessment (p<0.05). VO2peak significantly increased from 16.27±4.2 pre-intervention to 20.03±2.6 ml/kg/min post-intervention (p=0.049) whereas VE/VCO2 slightly decreased with a non-significant difference at the end of the study program (p=0.594) indicating animprovement of ventilator efficiencyand overall cardiorespiratory fitness.Conclusion Short-term application of low-intensity aerobic exercise (4 weeks) may improve the quality of sleep and ventilator efficiency in elderly HF patients. The study findings encourage elderly HF patients with sleep disturbance to adhere to the exercise training program. Also, cardiac rehabilitation programs with low intensity of aerobic exercise should be proposed to these patients by their health care provider.

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Section: Resultssupporting

confidence: 93%

Sleep quality and ventilatory efficiency in elderly heart failure patients: a pilot study on the short-term effect of 4-week low-intensity aerobic exercise

Abdelbasset

Osailan

2020

Kardiologiia

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“…While these findings are encouraging, the subjects involved in the study were those with ejection fraction > 40% rather than ≥50%. Aside from the pharmacological treatment, there is evidence that aerobic exercise can improve the peak oxygen consumption and quality of life in patients with HFpEF (56). Recently, Ge et al introduced a clinical phenotypic classification of HFpEF (57), which provides a better understanding of the risk factors, etiology, pathophysiology, and clinical course of HFpEF and contributes to guiding the targeted treatment.…”

Section: Future Prospects For Hfpefmentioning

confidence: 99%

Predictive Value of HFA-PEFF Score in Patients With Heart Failure With Preserved Ejection Fraction

Sun

et al. 2021

Front. Cardiovasc. Med.

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Aims: HFA-PEFF score has been proposed for diagnosing heart failure with preserved ejection fraction (HFpEF). Currently, there are only a limited number of tools for predicting the prognosis. In this study, we evaluated whether the HFA-PEFF score can predict mortality in patients with HFpEF.Methods: This single-center, retrospective observational study enrolled patients diagnosed with HFpEF at the First Affiliated Hospital of Dalian Medical University between January 1, 2015, and April 30, 2018. The subjects were divided according to their HFA-PEFF score into low (0–2 points), intermediate (3–4 points), and high (5–6 points) score groups. The primary outcome was all-cause mortality.Results: A total of 358 patients (mean age: 70.21 ± 8.64 years, 58.1% female) were included. Of these, 63 (17.6%), 156 (43.6%), and 139 (38.8%) were classified into the low, intermediate, and high score groups, respectively. Over a mean follow-up of 26.9 months, 46 patients (12.8%) died. The percentage of patients who died in the low, intermediate, and high score groups were 1 (1.6%), 18 (11.5%), and 27 (19.4%), respectively. A multivariate Cox regression identified HFA-PEFF score as an independent predictor of all-cause mortality [hazard ratio (HR):1.314, 95% CI: 1.013–1.705, P = 0.039]. A Cox analysis demonstrated a significantly higher rate of mortality in the intermediate (HR: 4.912, 95% CI 1.154–20.907, P = 0.031) and high score groups (HR: 5.291, 95% CI: 1.239–22.593, P = 0.024) than the low score group. A receiver operating characteristic (ROC) analysis indicated that the HFA-PEFF score can effectively predict all-cause mortality after adjusting for age and New York Heart Association (NYHA) class [area under the curve (AUC) 0.726, 95% CI 0.651–0.800, P = 0.000]. With an HFA-PEFF score cut-off value of 3.5, the sensitivity and specificity were 78.3 and 54.8%, respectively. The AUC on ROC analysis for the biomarker component of the score was similar to that of the total score.Conclusions: The HFA-PEFF score can be used both to diagnose HFpEF and predict the prognosis. The higher scores are associated with higher all-cause mortality.

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“…Peak oxygen consumption has also been found to increase with exercise training in heart failure. The effect is thought to be mediated via several pathways, including reversal of concentric remodeling with subsequent improvements of myocardial contractility and compliance, as well as improved microvascular circulation, oxygen extraction and metabolic function of large muscle groups [40][41][42]. Furthermore, a combination of aerobic and resistance training has been shown to elicit greater improvements in aerobic capacity as compared to aerobic exercise alone [43].…”

Section: Effects Of Exercise Training In Heart Failurementioning

confidence: 99%

“…Furthermore, a combination of aerobic and resistance training has been shown to elicit greater improvements in aerobic capacity as compared to aerobic exercise alone [43]. Metaanalyses have shown that exercise protocols have a positive impact on exercise capacity and quality of life [40,44] in patients with heart failure. Effects on mortality and rehospitalization have also been found, albeit modest [44].…”

Section: Effects Of Exercise Training In Heart Failurementioning

confidence: 99%

“…Indeed, the importance of weight management has been underscored by studies showing an additive effect of weight loss and exercise training among overweight individuals on functional capacity in patients with HFpEF [59]. Although studies of exercise training in HFpEF have been fewer, results from a recent meta-analysis shows that aerobic training elicits similar effects on aerobic capacity in HFpEF as in HFrEF, with an average increase of about 15% [40], well above a clinically significant threshold increase of around 10% [60]. Importantly, the similar effects on quality of life measures underscore the importance of cardiac rehabilitation regardless of ejection fraction [44,61].…”

Section: Heart Failure With Preserved Ejection Fractionmentioning

confidence: 99%

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The importance of physical activity and cardiorespiratory fitness for patients with heart failure

Lindgren

Börjesson

2021

Diabetes Research and Clinical Practice

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The present review highlights current research on the importance of PA and fitness for patients with heart failure and recommendations with respect to heart failure phenotypes and special populations. Furthermore, the evidence for various exercise types and intensities/doses as an ''exercise prescription", are discussed.The strong association between heart failure and traditional risk factors, physical inactivity and low fitness, underlines the importance of regular PA and exercise for prevention and treatment of heart failure. This is illustrated by cardiac stiffness which typically accelerates in middle-life and could be reversed by aerobic exercise. In patients with HFpEF, regular PA counteracts many of the changes observed, both metabolic and functional. Indeed, exercise-based cardiac rehabilitation has received a class 1A recommendation in current guidelines [1], in order to improve functional capacity, quality of life and lower the risk of rehospitalization.An individually tailored plan based on risk stratification, clinical assessment and cardiopulmonary exercise testing is encouraged before initiation of exercise training in patients with heart failure. In general, a combination of aerobic exercise and resistance training protocols is recommended (Table 1) [2], preferably throughout life. More studies are needed, regarding the role of PA and exercise in specific populations, such as frail patients with heart failure.

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Effect of Aerobic Exercise on Peak Oxygen Consumption, VE/VCO2 Slope, and Health-Related Quality of Life in Patients with Heart Failure with Preserved Left Ventricular Ejection Fraction: a Systematic Review and Meta-Analysis

Cited by 21 publications

References 37 publications

Sleep quality and ventilatory efficiency in elderly heart failure patients: a pilot study on the short-term effect of 4-week low-intensity aerobic exercise

Sleep quality and ventilatory efficiency in elderly heart failure patients: a pilot study on the short-term effect of 4-week low-intensity aerobic exercise

Predictive Value of HFA-PEFF Score in Patients With Heart Failure With Preserved Ejection Fraction

The importance of physical activity and cardiorespiratory fitness for patients with heart failure

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