Exercise Intolerance in Heart Failure with Preserved Ejection Fraction

Heart Fail Clin. 2021 Jul;17(3):397-413. doi: 10.1016/j.hfc.2021.03.004.

Abstract

Exercise intolerance represents a typical feature of heart failure with preserved ejection fraction (HFpEF), and is associated with a poor quality of life, frequent hospitalizations, and increased all-cause mortality. The cardiopulmonary exercise test is the best method to quantify exercise intolerance, and allows detection of the main mechanism responsible for the exercise limitation, influencing treatment and prognosis. Exercise training programs improve exercise tolerance in HFpEF. However, studies are needed to identify appropriate type and duration. This article discusses the pathophysiology of exercise limitation in HFpEF, describes methods of determining exercise tolerance class, and evaluates prognostic implications and potential therapeutic strategies.

Keywords: Aerobic capacity; Cardiac function; Exercise tolerance; Exercise training; Heart failure with preserved ejection fraction; Skeletal muscle function.

Publication types

  • Review

MeSH terms

  • Exercise Test
  • Exercise Therapy / methods*
  • Exercise Tolerance / physiology*
  • Heart Failure / physiopathology*
  • Heart Failure / therapy
  • Humans
  • Prognosis
  • Quality of Life*
  • Stroke Volume / physiology*