Photo Credit: Drazen Zigic

The following is a summary of “Hemodynamic Response to Exercise Training in Heart Failure With Reduced Ejection Fraction Patients,” published in the February 2024 issue of Cardiology by Kirsch et al.

Supervised exercise training can improve heart function in patients with HFrEF. However, individual responses vary, and the reasons for this are unclear.

Researchers conducted a retrospective study comparing cardiac hemodynamic changes after exercise in responders (R) vs non-responders (NR) patients with HFrEF and comparing methods to measure response. 

They enrolled 76 patients with HFrEF (86% males, 57 ± 12 years), in a 4-week exercise program. Before and after the training, patients underwent cycling tests measuring their heart function. Also, impedance cardiography was used to monitor cardiac hemodynamics, and the R and NR groups were classified using the median change in peak oxygen uptake (VO_2peak).

The results showed that training showed big improvements in responders for VO_2peak (35% vs. -1%, P<0.0001) and in peak ventilation (+30% vs. +2%, P<0.0001), Cardiac output (CO_peak) (+25% vs +4%, P<0.01), systolic blood pressure (+12% vs. +2%, P<0.05), diastolic blood pressure (+9% vs. +4%, P< 0.05) and heart rate (+8% vs. +1%, P< 0.01) compared to the NR group. V̇O_2peakwas the best indicator of response ([ROC] area under the curve [AUC] = 0.83, P<0.0001), followed by CO_peak (ROC AUC = 0.77, P<0.0001). 

Investigators concluded that V̇O_2peak stands out as the top indicator between R and NR groups to training where R had better heart function. This warrants more research on tailoring exercise programs based on individual needs and peak heart performance. 

Source: cardiologyres.org/index.php/Cardiologyres/article/view/1591/1540