Exercise Intolerance in Older Adults With Heart Failure With Preserved Ejection Fraction: JACC State-of-the-Art...

Area of Science:

• Gerontology
• Cardiovascular Medicine
• Geriatrics

Background:

• Exercise intolerance (EI) is a primary symptom of chronic heart failure with preserved ejection fraction (HFpEF).
• HFpEF is the most common heart failure type in older individuals.
• HFpEF is increasingly recognized as a systemic, multi-organ disorder with aging-related characteristics.

Purpose of the Study:

• To review aging-related and extracardiac factors contributing to EI in HFpEF.
• To propose a transdisciplinary, gero-centric approach for understanding EI in HFpEF.
• To identify novel therapeutic targets by integrating aging and cardiovascular disease research.

Main Methods:

• This review is based on a National Institute of Aging-sponsored working group meeting.
• Discussion of aging-related and extracardiac contributors to EI in HFpEF.
• Development of a framework for future research prioritization.

Main Results:

• Aging and extracardiac factors significantly contribute to EI in HFpEF.
• A gero-centric perspective is crucial for advancing understanding of HFpEF.
• Integrating gerontology and cardiovascular research offers new therapeutic avenues.

Conclusions:

• A transdisciplinary approach is needed to address EI in HFpEF.
• Future research should focus on uniform phenotyping, geroscience targets, and proof-of-concept trials.
• Targeting aging mechanisms may yield novel treatments for HFpEF-associated exercise intolerance.