%0 Journal Article %1 Edelmann.2011 %A Edelmann, Frank %A Gelbrich, Götz %A Düngen, Hans-Dirk %A Fröhling, Stefan %A Wachter, Rolf %A Stahrenberg, Raoul %A Binder, Lutz %A Töpper, Agnieszka %A Lashki, Diana Jahandar %A Schwarz, Silja %A Herrmann-Lingen, Christoph %A Loeffler, Markus %A Hasenfuss, Gerd %A Halle, Martin %A Pieske, Burkert %D 2011 %J Journal of the American College of Cardiology %K IMISE-Publikationen %N 17 %P 1780–1791 %T Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study %V 58 %X OBJECTIVES\r\nWe sought to determine whether structured exercise training (ET) improves maximal exercise capacity, left ventricular diastolic function, and quality of life (QoL) in patients with heart failure with preserved ejection fraction (HFpEF).\r\nBACKGROUND\r\nNearly one-half of patients with heart failure experience HFpEF, but effective therapeutic strategies are sparse.\r\nMETHODS\r\nA total of 64 patients (age 65 ± 7 years, 56\% female) with HFpEF were prospectively randomized (2:1) to supervised endurance/resistance training in addition to usual care (ET, n = 44) or to usual care alone (UC) (n = 20). The primary endpoint was the change in peak Vo(2) after 3 months. Secondary endpoints included effects on cardiac structure, diastolic function, and QoL.\r\nRESULTS\r\nPeak Vo(2) increased (16.1 ± 4.9 ml/min/kg to 18.7 ± 5.4 ml/min/kg; p < 0.001) with ET and remained unchanged (16.7 ± 4.7 ml/min/kg to 16.0 ± 6.0 ml/min/kg; p = NS) with UC. The mean benefit of ET was 3.3 ml/min/kg (95\% confidence interval CI: 1.8 to 4.8, p < 0.001). E/e' (mean difference of changes: -3.2, 95\% CI: -4.3 to -2.1, p < 0.001) and left atrial volume index (milliliters per square meter) decreased with ET and remained unchanged with UC (-4.0, 95\% CI: -5.9 to -2.2, p < 0.001). The physical functioning score (36-Item Short-Form Health Survey) improved with ET and remained unchanged with UC (15, 95\% CI: 7 to 24, p < 0.001). The ET-induced decrease of E/e' was associated with 38\% gain in peak Vo(2) and 50\% of the improvement in physical functioning score.\r\nCONCLUSIONS\r\nExercise training improves exercise capacity and physical dimensions of QoL in HFpEF. This benefit is associated with atrial reverse remodeling and improved left ventricular diastolic function. (Exercise Training in Diastolic Heart Failure-Pilot Study: A Prospective, Randomised, Controlled Study to Determine the Effects of Physical Training on Exercise Capacity and Quality of Life Ex-DHF-P; ISRCTN42524037).

@article{Edelmann.2011, abstract = {OBJECTIVES\r\nWe sought to determine whether structured exercise training (ET) improves maximal exercise capacity, left ventricular diastolic function, and quality of life (QoL) in patients with heart failure with preserved ejection fraction (HFpEF).\r\nBACKGROUND\r\nNearly one-half of patients with heart failure experience HFpEF, but effective therapeutic strategies are sparse.\r\nMETHODS\r\nA total of 64 patients (age 65 ± 7 years, 56\% female) with HFpEF were prospectively randomized (2:1) to supervised endurance/resistance training in addition to usual care (ET, n = 44) or to usual care alone (UC) (n = 20). The primary endpoint was the change in peak Vo(2) after 3 months. Secondary endpoints included effects on cardiac structure, diastolic function, and QoL.\r\nRESULTS\r\nPeak Vo(2) increased (16.1 ± 4.9 ml/min/kg to 18.7 ± 5.4 ml/min/kg; p < 0.001) with ET and remained unchanged (16.7 ± 4.7 ml/min/kg to 16.0 ± 6.0 ml/min/kg; p = NS) with UC. The mean benefit of ET was 3.3 ml/min/kg (95\% confidence interval [CI]: 1.8 to 4.8, p < 0.001). E/e' (mean difference of changes: -3.2, 95\% CI: -4.3 to -2.1, p < 0.001) and left atrial volume index (milliliters per square meter) decreased with ET and remained unchanged with UC (-4.0, 95\% CI: -5.9 to -2.2, p < 0.001). The physical functioning score (36-Item Short-Form Health Survey) improved with ET and remained unchanged with UC (15, 95\% CI: 7 to 24, p < 0.001). The ET-induced decrease of E/e' was associated with 38\% gain in peak Vo(2) and 50\% of the improvement in physical functioning score.\r\nCONCLUSIONS\r\nExercise training improves exercise capacity and physical dimensions of QoL in HFpEF. This benefit is associated with atrial reverse remodeling and improved left ventricular diastolic function. (Exercise Training in Diastolic Heart Failure-Pilot Study: A Prospective, Randomised, Controlled Study to Determine the Effects of Physical Training on Exercise Capacity and Quality of Life [Ex-DHF-P]; ISRCTN42524037).}, added-at = {2014-10-14T15:27:56.000+0200}, author = {Edelmann, Frank and Gelbrich, Götz and Düngen, Hans-Dirk and Fröhling, Stefan and Wachter, Rolf and Stahrenberg, Raoul and Binder, Lutz and Töpper, Agnieszka and Lashki, Diana Jahandar and Schwarz, Silja and Herrmann-Lingen, Christoph and Loeffler, Markus and Hasenfuss, Gerd and Halle, Martin and Pieske, Burkert}, biburl = {https://www.bibsonomy.org/bibtex/2b635ea4b19dac3e3adb9d7169173107c/drtester}, interhash = {513f87e00c30489c3d86eb788e1e538b}, intrahash = {b635ea4b19dac3e3adb9d7169173107c}, journal = {Journal of the American College of Cardiology}, keywords = {IMISE-Publikationen}, number = 17, pages = {1780–1791}, timestamp = {2014-12-03T00:08:19.000+0100}, title = {Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study}, volume = 58, year = 2011 }