Heart Failure Preserved Ejection Fraction
Conditions
Keywords
Resistance Training, Exercise, Heart Failure preserved Ejection Fraction
Brief summary
The objective of this proposal is to determine the effect of resistance exercise training on locomotor muscle function, exercise capacity, exertional symptoms, and quality of life in HF patients with preserved ejection fraction (HFpEF).
Detailed description
In this randomized controlled pilot study of resistance exercise training in patients with HFpEF, the investigators will recruit 24 HFpEF patients who will be randomized to resistance exercise training (RT - n=12) or no resistance exercise training (standard care control group \[CTL\] - n=12). The investigators will have baseline and follow-up measures of clinical characteristics, leg muscle strength, quality of life, lean muscle mass (body composition via DXA including segmental lean mass), maximal cardiopulmonary exercise test (peak VO2, peak work, ventilatory efficiency), constant-load submaximal cardiopulmonary exercise test with speckle tracking echocardiography (exertional dyspnea and fatigue at matched workloads, cardiac output, diastolic function, left ventricular strain, ventilation, gas exchange, and locomotor muscle neural feedback). Participants will be asked to make 4 separate study visits. Those randomized to undergo Resistance Training will be expected to make those visits as well.
Interventions
OTHERResistance Exercise Training
1. Aerobic Exercise a. Each participant will engage in 5 minutes of aerobic based exercise on an arm/leg ergometer (NuStep Cross Trainer) at an intensity of 12-14 on the Borg Rating of Perceived Exertion Scale as a warm-up prior to the exercise session and again as a cool-down at the end of the exercise session. 2. Resistance Exercise - 2 sets of 8-12 repetitions - beginning at 60% of the initial 1 RM. a) Leg Extension, b) Bicep Curl, c) Leg Press, d) Chest Press, e) Leg Curl, f)Seated Row (horizontal or pulldown), g) Calf Raises 3. Core Strengthening Exercises a. 5-10 minutes of stability ball and balance exercises
RADIATIONDEXA bone scan
A DEXA scan that provides bone density measures.
OTHERCardiopulmonary Max Exercise Test
Pedaling on a cycle ergometer to volitional fatigue.
OTHERQuality of Life Questionnaire
A 10 minute questionnaire that measures quality of life.
Two short submaximal constant-load exercise sessions at 20 Watts. Each session will include 6 minutes of cycling (baseline). Following baseline, the sessions will be randomized to continued constant-load cycling for an additional 9 minutes (for echocardiographic measures) or randomized sub-systolic inflation of bilateral thigh pressure tourniquets to 40 and 80 mmHg for 3 minutes with 3 minutes of deflation between inflations to stimulate locomotor muscle neural feedback.
OTHERBlood Draw
A blood draw amounting to 1 teaspoon of blood drawn.
Sponsors
Mayo Clinic
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
All patients will be managed by their primary care physician or cardiologist with additional review and oversight by Dr. Borlaug (Co-Investigator) prior to enrollment to ensure adequacy of inclusion and
Exclusion criteria
and that participation in exercise testing and resistance exercise training is safe. Inclusion Criteria, includes: * Clinical diagnosis of HFpEF. * Patients 18-80 yrs old with a history stable (no medication changes in past 6 weeks (w/duration of diagnosis \>6 months). * New York Heart Association class I-III. * Ejection fraction ≥40%. * Current non-smokers with \<15 pack year history. * Non-pregnant women, and individuals who are able to exercise (i.e. without orthopedic limitations or neuromuscular disorders).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Bone density and strength | 12 weeks | DEXA scan |
| Cardiopulmonary Function | 12 weeks | Cardiopulmonary bike exercise |
| Quality of Life | 12 weeks | Questionnaire |
| Blood Biomarkers | 12 weeks | Blood draw |
Countries
United States
Outcome results
None listed