Participation in an exercise-based cardiac rehabilitation program and functional improvement of heart failure patients with preserved versus reduced left ventricular systolic function

Background: About half of all patients with heart failure are diagnosed with heart failure preserved ejection fraction (HFpEF). Until now, studies have failed to show that medical treatment improves the prognosis of patients with HFpEF. Objectives: To evaluate changes in exercise capacity of patients with HFpEF compared to those with heart failure with reduced ejection fraction (HFrEF) following an exercise training program. Methods: Patient data was retrieved from a multi-center registry of patients with heart failure who participated in a cardiac rehabilitation program. Patients underwent exercise testing and an echocardiogram prior to entering the program and were retested 6 months later. Results: Of 216 heart failure patients enrolled in the program, 170 were diagnosed with HFrEF and 46 (21%) with HFpEF. Patients with HFpEF had lower baseline exercise 6 capacity compared to those with HFrEF. Participating in a month exercise program resulted in significant and similar improvement in exercise performance of both HFpEF and HFrEF (1.45 patients: an absolute metabolic equivalent (MET) change 1.1 in the HFpEF group, P = 0.3). METs in HFrEF patients vs. Conclusions: An exercise training program resulted in similar improvement of exercise capacity in both HFpEF and HFrEF patients. An individualized, yet similarly structured, cardiac rehabilitation program may serve both heart failure groups, providing safety and efficacy.