Physical activity and exercise training in heart failure with preserved ejection fraction: gathering evidence from clinical and pre-clinical studies
- 8 May 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Heart Failure Reviews
- Vol. 27 (2), 573-586
- https://doi.org/10.1007/s10741-020-09973-5
Abstract
Conventional treatments for heart failure have failed to improve survival in heart failure with preserved ejection fraction (HFpEF). The current therapy recommendations highlight the importance of symptom management and improvement of patient’s well-being or other health-related outcomes. Physical activity/exercise training might be an adjuvant treatment option, since several studies in HFpEF patients reported beneficial effects on exercise intolerance, which is the main symptom associated with this disease. In addition, exercise training was shown to improve quality of life and, in some studies, to improve cardiac function. However, the mechanisms behind these effects are not completely known. The objective of this narrative review is to summarize the main clinical findings regarding the role of physical activity/exercise training in several outcomes, such as hospitalization and mortality, exercise capacity, quality of life, and cardiac function and remodeling. In addition, we will briefly discuss the findings provided by pre-clinical studies. In conclusion, while the impact of physical activity/exercise training on exercise intolerance and quality of life is already well known, its effect on mortality and hospitalization is not well documented, and whether it benefits diastolic function needs further investigation. Some clinical studies showed that exercise training can improve diastolic function, and evidences from pre-clinical studies suggest that this effect is mediated through reduced myocardial stiffness.Keywords
Funding Information
- Fundação para a Ciência e a Tecnologia (PTDC/MEC-CAR/30011/2017, UID/IC/00051/2019, UID/DTP/00617/2019)
- European Regional Development Fund (POCI-01-0145-FEDER-030011)
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (BEX 0554/14-6)
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