title: Clinical utility of exercise training in heart failure with reduced and preserved ejection fraction.
abstract: Reduced exercise tolerance is an independent predictor of hospital readmission and mortality in patients with heart failure (HF). Exercise training for HF patients is well established as an adjunct therapy, and there is sufficient evidence to support the favorable role of exercise training programs for HF patients over and above the optimal medical therapy. Some of the documented benefits include improved functional capacity, quality of life (QoL), fatigue, and dyspnea. Major trials to assess exercise training in HF have, however, focused on heart failure with reduced ejection fraction (HFREF). At least half of the patients presenting with HF have heart failure with preserved ejection fraction (HFPEF) and experience similar symptoms of exercise intolerance, dyspnea, and early fatigue, and similar mortality risk and rehospitalization rates. The role of exercise training in the management of HFPEF remains less clear. This article provides a brief overview of pathophysiology of reduced exercise tolerance in HFREF and heart failure with preserved ejection fraction (HFPEF), and summarizes the evidence and mechanisms by which exercise training can improve symptoms and HF. Clinical and practical aspects of exercise training prescription are also discussed.
authors.affiliation: Northern Heart, The Northern Hospital, Melbourne, Vic, Australia. ; Austin Health, Melbourne, Vic, Australia. ; University of Melbourne, Melbourne, Vic, Australia.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Asrar Ul Haq
authors.affiliation: Northern Heart, The Northern Hospital, Melbourne, Vic, Australia.
authors.forename: Cheng Yee
authors.initials: CY
authors.lastname: Goh
authors.affiliation: Institute of Sport, Exercise and Active Living (ISEAL), College of Sport and Exercise Science, Victoria University, Melbourne, Australia.
authors.forename: Itamar
authors.initials: I
authors.lastname: Levinger
authors.affiliation: Northern Heart, The Northern Hospital, Melbourne, Vic, Australia. ; University of Melbourne, Melbourne, Vic, Australia.
authors.forename: Chiew
authors.initials: C
authors.lastname: Wong
authors.affiliation: Austin Health, Melbourne, Vic, Australia. ; University of Melbourne, Melbourne, Vic, Australia.
authors.forename: David L
authors.initials: DL
authors.lastname: Hare
keywords: HFPEF; exercise; heart failure