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Hemodynamic Response to Exercise Training in Heart Failure With Reduced Ejection Fraction Patients
Marine Kirsch1, Marie-Christine Iliou2, Damien Vitiello1
1Institut des Sciences du Sport Sante de Paris (I3SP), URP 3625, Universite Paris Cite, Paris 75015, France.
Cardiology Research
|March 11, 2024
Summary
Peak oxygen uptake (V̇O2peak) best identifies responders to exercise training in heart failure with reduced ejection fraction (HFrEF) patients. Responders showed significant improvements in cardiac output and blood pressure, indicating better training adaptation.
Area of Science:
- Cardiology
- Exercise Physiology
- Rehabilitation Medicine
Background:
- Supervised exercise training improves outcomes in heart failure with reduced ejection fraction (HFrEF).
- Individual patient response to exercise training is variable.
- Factors influencing training response in HFrEF remain unclear.
Purpose of the Study:
- Compare cardiac hemodynamic changes in HFrEF exercise training responders (R) versus non-responders (NR).
- Evaluate discriminators for assessing training response in HFrEF patients.
Main Methods:
- Seventy-six HFrEF patients completed a 4-week supervised exercise program.
- Cardiopulmonary exercise testing (CPET) and impedance cardiography were used before and after training.
- Responders and non-responders were classified by peak oxygen uptake (V̇O2peak) change.
Main Results:
- Responders showed a 35% increase in V̇O2peak, while non-responders had a 1% decrease (P < 0.0001).
- Responders exhibited significant improvements in peak cardiac output (COpeak), systolic and diastolic blood pressure, and heart rate compared to non-responders.
- V̇O2peak was the best discriminator between responders and non-responders (ROC AUC = 0.83), followed by COpeak (ROC AUC = 0.77).
Conclusions:
- Peak oxygen uptake (V̇O2peak) is the optimal discriminator for HFrEF exercise training response.
- Exercise training responders demonstrate enhanced peak hemodynamic function.
- Future research should focus on individualizing exercise programs based on hemodynamic parameters to optimize HFrEF patient outcomes.
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