Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep 26;13(9):514-525.
doi: 10.4330/wjc.v13.i9.514.

Effects of exercise training on diastolic and systolic dysfunction in patients with chronic heart failure

Ioannis Chaveles  1 , Ourania Papazachou  2 , Manal Al Shamari  3 , Dimitrios Delis  3 , Argirios Ntalianis  4 , Niki Panagopoulou  2 , Serafim Nanas  3 , Eleftherios Karatzanos  5
Affiliations

Effects of exercise training on diastolic and systolic dysfunction in patients with chronic heart failure

Ioannis Chaveles et al. World J Cardiol. .

Abstract

Background: Chronic heart failure (CHF) is a complex syndrome characterized by a progressive reduction of the left ventricular (LV) contractility, low exercise tolerance, and increased mortality and morbidity. Diastolic dysfunction (DD) of the LV, is a keystone in the pathophysiology of CHF and plays a major role in the progression of most cardiac diseases. Also, it is well estimated that exercise training induces several beneficial effects on patients with CHF.

Aim: To evaluate the impact of a cardiac rehabilitation program on the DD and LV ejection fraction (EF) in patients with CHF.

Methods: Thirty-two stable patients with CHF (age: 56 ± 10 years, EF: 32% ± 8%, 88% men) participated in an exercise rehabilitation program. They were randomly assigned to aerobic exercise (AER) or combined aerobic and strength training (COM), based on age and peak oxygen uptake, as stratified randomization criteria. Before and after the program, they underwent a symptom-limited maximal cardiopulmonary exercise testing (CPET) and serial echocardiography evaluation to evaluate peak oxygen uptake (VO2peak), peak workload (Wpeak), DD grade, right ventricular systolic pressure (RVSP), and EF.

Results: The whole cohort improved VO2peak, and Wpeak, as well as DD grade (P < 0.05). Overall, 9 patients (28.1%) improved DD grade, while 23 (71.9%) remained at the same DD grade; this was a significant difference, considering DD grade at baseline (P < 0.05). In addition, the whole cohort improved RVSP and EF (P < 0.05). Not any between-group differences were observed in the variables assessed (P > 0.05).

Conclusion: Exercise rehabilitation improves indices of diastolic and systolic dysfunction. Exercise protocol was not observed to affect outcomes. These results need to be further investigated in larger samples.

Keywords: Aerobic exercise; Cardiac rehabilitation; Cardiovascular effects; Chronic heart failure; Diastolic dysfunction; Strength training.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Changes in diastolic dysfunction grades. A: Pre- and post-number of grade-0, -I, -II, -III patients (P = 0.01, as assessed with Wilcoxon signed-rank test); B: Patients’ distribution according to pre- and post-level of grade (P = -0.06, as analyzed with McNemar-Bowker test); C: Number of patients that decreased grade or remained at the same grade in relation to baseline grade (P < 0.01, as assessed with χ2 test).
Figure 2
Figure 2
Values of VΟ2peak(A) and Wpeak(B) before and after the program for the groups of patients according to DD grade alteration i.e. "decreased grade" vs "no grade change". aP < 0.05, significant within-group difference.
See this image and copyright information in PMC

References

    1. Piepoli MF, Guazzi M, Boriani G, Cicoira M, Corrà U, Dalla Libera L, Emdin M, Mele D, Passino C, Vescovo G, Vigorito C, Villani GQ, Agostoni P Working Group 'Exercise Physiology, Sport Cardiology and Cardiac Rehabilitation', Italian Society of Cardiology. Exercise intolerance in chronic heart failure: mechanisms and therapies. Part I. Eur J Cardiovasc Prev Rehabil. 2010;17:637–642. - PubMed
    1. Yu CM, Lin H, Yang H, Kong SL, Zhang Q, Lee SW. Progression of systolic abnormalities in patients with "isolated" diastolic heart failure and diastolic dysfunction. Circulation. 2002;105:1195–1201. - PubMed
    1. Zile MR, Brutsaert DL. New concepts in diastolic dysfunction and diastolic heart failure: Part I: diagnosis, prognosis, and measurements of diastolic function. Circulation. 2002;105:1387–1393. - PubMed
    1. Hamlin SK, Villars PS, Kanusky JT, Shaw AD. Role of diastole in left ventricular function, II: diagnosis and treatment. Am J Crit Care. 2004;13:453–66; quiz 467. - PubMed
    1. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelista A. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009;22:107–133. - PubMed