PRIME-HF: Novel Exercise for Older Patients with Heart Failure. A Pilot Randomized Controlled Study

Area of Science:

• Cardiology
• Exercise Physiology
• Geriatrics

Background:

• Heart failure with reduced ejection fraction (HFrEF) affects older adults, necessitating safe and effective exercise interventions.
• Traditional exercise programs like combined aerobic and resistance training (COMBO) are used, but their effectiveness in older HFrEF patients needs further evaluation.

Purpose of the Study:

• To assess the tolerability of COMBO training in older patients with HFrEF.
• To compare the effectiveness of a phased exercise approach (PRIME followed by COMBO) against 8 weeks of COMBO alone in improving aerobic capacity and muscle strength.

Main Methods:

• A prospective randomized controlled trial involving 19 older adults with HFrEF.
• Participants were assigned to either 4 weeks of PRIME followed by 4 weeks of COMBO, or 8 weeks of COMBO.
• Exercise interventions were conducted twice weekly, with PRIME focusing on high-repetition resistance and COMBO combining aerobic and resistance training.

Main Results:

• The PRIME group demonstrated significant improvements in peak oxygen consumption (VO2peak) and oxygen consumption at anaerobic threshold (AT), with large effect sizes.
• While both groups improved muscle voluntary contraction (MVC), the COMBO group showed a larger increase.
• PRIME training resulted in statistically and clinically significant improvements in aerobic capacity, unlike the COMBO group.

Conclusions:

• Both PRIME and COMBO training improved muscle strength in older HFrEF patients.
• PRIME training emerged as a superior modality for enhancing aerobic capacity in this population.
• PRIME presents a promising alternative exercise strategy for older individuals with HFrEF.