Effects of exercise training for heart failure with preserved ejection fraction: A systematic review and meta-analysis of comparative studies

Taylor, Rod S; Davies, Edward J.; Dalal, Hasnain M; Davis, Russell; Doherty, Patrick; Cooper, Chris; Holland, David J.; Jolly, Kate; Smart, Neil A.

doi:10.1016/j.ijcard.2012.05.070

Cited by 91 publications

(83 citation statements)

References 53 publications

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“…Exercise training confers benefit in terms of enhancements in exercise capacity and health‐related quality of life29 in HFpEF patients. The processes behind better exercise capacity are complex and tend to reduce the level of muscle atrophy, inflammation, and catabolic/anabolic imbalance through molecular mechanisms 30.…”

Section: Discussionmentioning

confidence: 99%

Ghrelin and hormonal markers under exercise training in patients with heart failure with preserved ejection fraction: results from the Ex‐DHF pilot study

et al. 2016

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BackgroundOver 50% of patients with symptomatic heart failure (HF) experience HF with preserved ejection fraction (HFpEF). Exercise training (ET) is effective in improving cardiorespiratory fitness and dimensions of quality of life in patients with HFpEF. A systemic pro‐inflammatory state induced by comorbidities as the cause of myocardial structural and functional alterations has been proposed in HFpEF. ET modifies myocardial structure and has been related to inflammatory state. We investigated Ghrelin, related adipokines, markers of inflammation, and neuro‐hormonal activation in patients undergoing a structured ET vs. usual care are with HFpEF. Methods and resultsEx‐DHF‐P was a prospective, controlled, randomized multi‐centre trial on structured and supervised ET in patients with HFpEF. We performed a post hoc analysis in 62 patients from Ex‐DHF‐P. Ghrelin, adiponectin, leptin, IL‐1ß, IL‐6, IL‐10, tumour necrosis factor‐alpha, MR‐proANP, MR‐proADM, CT‐proET1, and CT‐proAVP were assessed to seize the impact of ET on these markers in patients with HFpEF. Thirty‐six (58%) patients were female, mean age was 64 years, and median ghrelin was 928 pg/mL (interquartile range 755–1156). When stratified for high versus low ghrelin, groups significantly differed at baseline in presence obesity, waist circumference, and adiponectin levels (P < 0.05, respectively). Overall, ghrelin levels rose significantly to 1013 pg/mL (interquartile range 813–1182) (P < 0.001). Analysis of covariance modelling for change in ghrelin identified ET (P = 0.013) and higher baseline adiponectin levels (P = 0.035) as influencing factors.ConclusionsExercise training tended to increase ghrelin levels in Ex‐DHF‐P. This increase was especially pronounced in patients with higher baseline adiponectin levels. Future trials are needed to investigate the effect of ET on endogenous ghrelin levels in regard to interactions with cardiac structure and clinically meaningful surrogate parameters.

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Section: Discussionmentioning

confidence: 99%

Ghrelin and hormonal markers under exercise training in patients with heart failure with preserved ejection fraction: results from the Ex‐DHF pilot study

et al. 2016

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“…The usefulness of other device treatments, such as resynchronisation therapy, remains unclear. However, physical training, which has favourable effects on endothelial function, vascular stiffness and skeletal muscle metabolism, is a targeted intervention that has proved to be effective for HFpEF (28).…”

Section: The Way Aheadmentioning

confidence: 99%

Hjertesvikt med bevart ejeksjonsfraksjon

Røe¹,

Sjaastad²,

Louch³

2017

Tidsskriftet

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“…[13] As beneficial effects of CR largely depend on continuation of a lifetime exercise program after a structured CR, patients should be encouraged to continue with an individual exercise program to preserve an improvement in exercise capacity. [8,10,11,[13][14][15][16][17][18] Reasons for non-participation in CR included unavailability of hospital-based CR, lack of motivation or other reasons e.g. excessive travel distance [19] Quality performance criteria, automated referral systems and options for home-based CR services may increase adherence to therapies in some patients.…”

Section: B Introductionmentioning

confidence: 99%