Exercise Training in Heart Failure: Current Evidence and Future Directions.

Area of Science:

• Cardiology
• Exercise Physiology
• Rehabilitation Medicine

Background:

• Heart Failure (HF) is a widespread condition with significant global healthcare impact.
• While pharmacological therapy is key for HFrEF survival, its impact on HFpEF mortality is not yet established.
• Exercise training (ET) is recognized for its role in improving prognosis and functional capacity in HF patients.

Purpose of the Study:

• To review the effects of ET on patients with HFpEF and HFrEF.
• To provide exercise modality recommendations for frail and sarcopenic HF subpopulations.
• To explore the impact of ET on quality of life, mental health, and clinical outcomes in HF.

Main Methods:

• Systematic review of existing literature on exercise training in heart failure.
• Analysis of studies investigating different exercise modalities (e.g., HIT, MCT, resistance training).
• Examination of factors influencing ET adherence and prescription rates.

Main Results:

• ET demonstrates benefits in peak oxygen consumption (pVO2) and 6-minute walk test distance for both HFrEF and HFpEF.
• Cardiac rehabilitation and ET improve functional capacity, exercise duration, and quality of life.
• ET shows positive effects on depression and anxiety, with potential reductions in hospitalisation and mortality rates.

Conclusions:

• Exercise training is a valuable component in managing both HFrEF and HFpEF.
• Supervised exercise programs enhance adherence, though prescription rates remain suboptimal.
• Larger, robust trials are necessary to define optimal, personalized ET strategies for diverse HF subtypes.