title: Effects of exercise training on different quality of life dimensions in heart failure with preserved ejection fraction: the Ex-DHF-P trial.
abstract: BACKGROUND
  Despite suffering from poor prognosis, progressive exercise intolerance, and impaired quality of life (QoL), effective therapeutic strategies in heart failure with preserved ejection fraction (HFpEF) are sparse. Exercise training (ET) improves physical QoL in HFpEF, but the effects on other aspects of QoL are unknown.
  
  
  METHODS
  The multicentre, prospective, randomized, controlled Exercise training in Diastolic Heart Failure Pilot study included 64 HFpEF patients (65 ± 7 years, 56% female). They were randomized to supervised endurance/resistance training in addition to usual care (ET, n = 44) or usual care alone (UC, n = 20). At baseline and after 3 months, QoL was assessed (36-item Short-form Health Survey (SF-36), Minnesota Living With Heart Failure Questionnaire (MLWHFQ), and Patient Health Questionnaire (PHQ-9).
  
  
  RESULTS
  Exercise improved the following SF-36 dimensions: physical functioning (p < 0.001, p = 0.001 vs. UC), bodily pain (p = 0.046), general health perception (p < 0.001, p = 0.016 vs. UC), general mental health (p =  0.002), vitality (p = 0.003), social functioning (p < 0.001) physical (p < 0.001, p = 0.001 vs. UC), and mental component score (p = 0.030). ET did not improve role limitations due to physical and emotional problems. The MLWHFQ total scale (p < 0.001) and the MLWHFQ physical limitation scale (p < 0.001, p = 0.04 vs. UC) also improved with ET. The MLWHFQ emotional limitation scale did not change with ET. With ET, also the PHQ-9 total score improved significantly (p = 0.004, p = 0.735 vs. UC).
  
  
  CONCLUSIONS
  In patients with HFpEF, exercise training improved emotional status, physical and social dimensions of QoL as well as symptoms of depression from pre to post test. Physical dimensions of QoL and general health perception also improved significantly with exercise in comparison to usual care.
authors.affiliation: Department of Cardiology, University of Göttingen, Göttingen, Germany.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Nolte
authors.affiliation: Department of Psychosomatic Medicine, University of Göttingen, Göttingen, Germany German Center for Cardiovascular Research (DZHK) Site Göttingen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Herrmann-Lingen
authors.affiliation: Department of Cardiology, University of Göttingen, Göttingen, Germany German Center for Cardiovascular Research (DZHK) Site Göttingen, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Wachter
authors.affiliation: Institute for Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
authors.forename: Götz
authors.initials: G
authors.lastname: Gelbrich
authors.affiliation: Department of Internal Medicine - Cardiology, Charité - Campus Virchow-Klinikum, University of Berlin, Augustenburger Platz 1, Berlin, Germany.
authors.forename: Hans-Dirk
authors.initials: HD
authors.lastname: Düngen
authors.affiliation: Department of Internal Medicine - Cardiology, Klinikum rechts der Isar, Technische Universität München, München, Germany.
authors.forename: André
authors.initials: A
authors.lastname: Duvinage
authors.affiliation: Department of Cardiology, University of Göttingen, Göttingen, Germany.
authors.forename: Nadine
authors.initials: N
authors.lastname: Hoischen
authors.affiliation: Department of Cardiology, University of Göttingen, Göttingen, Germany Department of Psychosomatic Medicine, University of Göttingen, Göttingen, Germany.
authors.forename: Karima
authors.initials: K
authors.lastname: von Oehsen
authors.affiliation: Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Munich, Germany.
authors.forename: Silja
authors.initials: S
authors.lastname: Schwarz
authors.affiliation: Department of Cardiology, University of Göttingen, Göttingen, Germany German Center for Cardiovascular Research (DZHK) Site Göttingen, Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Hasenfuss
authors.affiliation: Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Munich, Germany Munich Heart Alliance, Partner Site German Centre for Cardiovascular Research (DZHK), Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Halle
authors.affiliation: Department of Cardiology, Medical University of Graz, Graz, Austria.
authors.forename: Burkert
authors.initials: B
authors.lastname: Pieske
authors.affiliation: Department of Cardiology, University of Göttingen, Göttingen, Germany German Center for Cardiovascular Research (DZHK) Site Göttingen, Germany fedelmann@med.uni-goettingen.de.
authors.forename: Frank
authors.initials: F
authors.lastname: Edelmann
mesh_terms: D000368:Aged; D003863:Depression / Q000628:therapy; D015444:Exercise / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D013318:Stroke Volume / Q000502:physiology*; D011795:Surveys and Questionnaires
keywords: Depression; diastolic heart failure; exercise training; heart failure with preserved ejection fraction; quality of life