Effects of exercise training on different quality of life dimensions in heart failure with preserved ejection fraction: the Ex-DHF-P trial

Nolte, Kathleen; Herrmann‐Lingen, Christoph; Wachter, Rolf; Gelbrich, Götz; Düngen, Hans‐Dirk; Duvinage, André; Hoischen, Nadine; Oehsen, K. Von; Schwarz, Silja; Hasenfuß, Gerd; Halle, Martin; Pieske, Burkert; Edelmann, Frank

doi:10.1177/2047487314526071

Cited by 100 publications

(83 citation statements)

References 44 publications

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“…Dostępne są dowody wskazujące, że u pacjentów z HFpEF trening fizyczny przynosi wiele korzyści, w tym wpły-wa na poprawę wydolności wysiłkowej, określaną obiektywnie za pomocą oceny pochłaniania tlenu na szczycie wysiłku, poprawę jakości życia i funkcję rozkurczową ocenianą w badaniu echokardiograficznym [321,620,621,634].…”

Section: Trening Wysiłkowyunclassified

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Ponikowski

Voors

Anker³

et al. 2016

Kardiol Pol

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Section: Trening Wysiłkowyunclassified

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Ponikowski

Voors

Anker³

et al. 2016

Kardiol Pol

Self Cite

460

446

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“…Regular physical activity and structured exercise training (ET) are a cornerstone of non‐pharmacological management in HF patients 4, 5. ET was found to be effective in improving cardiorespiratory fitness6, 7 and dimensions of quality of life in patients with HFpEF 8. Strikingly, ET as a mean of cardiovascular rehabilitation has also been associated to improved left ventricular diastolic function in patients with reduced6 and preserved7 ejection fraction.…”

Section: Introductionmentioning

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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“…These positive findings are validated by other studies that reported the impact of exercise training on psychological effects among participants with heart failure. 18,36,37 Before our analysis, several competing theories could be offered to explain the lack of effect of exercise training on psychological outcomes. First, exercise may not be a powerful enough intervention to alter the emotional response of participants, many of whom have lived with a chronic, progressive syndrome for years.…”

Section: Discussionmentioning

confidence: 99%

Dose-Response Relationships between Exercise Intensity, Mood States, and Quality of Life in Heart Failure Patients

Evangelista

Cacciata

Strömberg

et al. 2016

Journal of Cardiac Failure

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Background: We conducted a secondary analysis to (1) compare changes in mood disorders and quality of life (QOL) among 4 groups of patients with heart failure in a home-based exercise program who had varying degrees of change in their exercise capacity and (2) determine whether there was an association between exercise capacity, mood disorders, and QOL. Methods: Seventy-one patients were divided into 4 groups based on changes in exercise capacity from baseline to 6 months: group 1showed improvements of greater than 10% (n = 19), group 2 showed improvements of 10% or less (n = 16), group 3 showed reductions of 10% or less (n = 9), and group 4 showed reductions of greater than 10% (n = 27). Results: Over time, patients in all 4 groups demonstrated significantly lower levels of depression and hostility (P G .001) and higher levels of physical and overall quality of life (P = .046). Group differences over time were noted in anxiety (P = .009), depression (P = .015), physical quality of life (P G .001), and overall quality of life (P = .002). Greater improvement in exercise capacity was strongly associated with lower depression scores (r = j0.49, P = .01). Conclusions: An improvement in exercise capacity with exercise training was associated with a decrease in depression and anxiety and an increase in QOL in patients with heart failure.

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Effects of exercise training on different quality of life dimensions in heart failure with preserved ejection fraction: the Ex-DHF-P trial

Cited by 100 publications

References 44 publications

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

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

Dose-Response Relationships between Exercise Intensity, Mood States, and Quality of Life in Heart Failure Patients

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