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Age-related effects of exercise training on diastolic function in heart failure with reduced ejection fraction: the Leipzig Exercise Intervention in Chronic Heart Failure and Aging (LEICA) Diastolic Dysfunction Study.
Eur Heart J 2012; 33(14):1758-68EH

Abstract

AIMS

Diastolic dysfunction (DD) was identified as a predictor of adverse prognosis in heart failure with reduced ejection fraction (HFREF). It is, however, unknown if DD is improved by exercise training, which is known to induce reverse remodelling, and if the training effect is attenuated in elderly HFREF patients. We therefore assessed DD in a cohort of referent controls (RCs) and HFREF patients and studied the response of DD to endurance exercise in two age groups (≤55 years and ≥65 years).

METHODS AND RESULTS

Sixty RC (30 ≤ 55 years, mean age 50 ± 5 years; 30 ≥ 65 years, 72 ± 4 years) and 60 HFREF patients (30 ≤ 55 years, 46 ± 5 years; 30 ≥ 65 years, 72 ± 5 years, EF 28 ± 5%) were randomized to 4 weeks of supervised endurance training or to a control group. Exercise training was effective in reducing LV isovolumetric relaxation time by 29% in young and by 26% in old HFREF patients (P< 0.05 for both). As assessed by tissue Doppler, septal E' increased by 37% in young and by 39% among old HFREF patients (P< 0.005 for both) resulting in a significant decrease in the E/E' ratio from 13 ± 1 to 10 ± 1 in young and 14 ± 1 to 11 ± 1 in old HFREF patients (P< 0.05 for both). Serum levels of N-terminal pro brain natriuretic peptide were significantly reduced after endurance training in HFREF patients of all ages.

CONCLUSION

In HFREF, diastolic function is significantly impaired in all age groups. Endurance training is highly effective in improving left ventricular diastolic function in HFREF patients regardless of age. This study is registered at ClinicalTrials.gov (number: NCT00176319).

Authors+Show Affiliations

Department of Internal Medicine/Cardiology, Heart Center, University of Leipzig, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22267243

Citation

Sandri, Marcus, et al. "Age-related Effects of Exercise Training On Diastolic Function in Heart Failure With Reduced Ejection Fraction: the Leipzig Exercise Intervention in Chronic Heart Failure and Aging (LEICA) Diastolic Dysfunction Study." European Heart Journal, vol. 33, no. 14, 2012, pp. 1758-68.
Sandri M, Kozarez I, Adams V, et al. Age-related effects of exercise training on diastolic function in heart failure with reduced ejection fraction: the Leipzig Exercise Intervention in Chronic Heart Failure and Aging (LEICA) Diastolic Dysfunction Study. Eur Heart J. 2012;33(14):1758-68.
Sandri, M., Kozarez, I., Adams, V., Mangner, N., Höllriegel, R., Erbs, S., ... Gielen, S. (2012). Age-related effects of exercise training on diastolic function in heart failure with reduced ejection fraction: the Leipzig Exercise Intervention in Chronic Heart Failure and Aging (LEICA) Diastolic Dysfunction Study. European Heart Journal, 33(14), pp. 1758-68. doi:10.1093/eurheartj/ehr469.
Sandri M, et al. Age-related Effects of Exercise Training On Diastolic Function in Heart Failure With Reduced Ejection Fraction: the Leipzig Exercise Intervention in Chronic Heart Failure and Aging (LEICA) Diastolic Dysfunction Study. Eur Heart J. 2012;33(14):1758-68. PubMed PMID: 22267243.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Age-related effects of exercise training on diastolic function in heart failure with reduced ejection fraction: the Leipzig Exercise Intervention in Chronic Heart Failure and Aging (LEICA) Diastolic Dysfunction Study. AU - Sandri,Marcus, AU - Kozarez,Irina, AU - Adams,Volker, AU - Mangner,Norman, AU - Höllriegel,Robert, AU - Erbs,Sandra, AU - Linke,Axel, AU - Möbius-Winkler,Sven, AU - Thiery,Joachim, AU - Kratzsch,Jürgen, AU - Teupser,Daniel, AU - Mende,Meinhard, AU - Hambrecht,Rainer, AU - Schuler,Gerhard, AU - Gielen,Stephan, Y1 - 2012/01/19/ PY - 2012/1/24/entrez PY - 2012/1/24/pubmed PY - 2012/10/10/medline SP - 1758 EP - 68 JF - European heart journal JO - Eur. Heart J. VL - 33 IS - 14 N2 - AIMS: Diastolic dysfunction (DD) was identified as a predictor of adverse prognosis in heart failure with reduced ejection fraction (HFREF). It is, however, unknown if DD is improved by exercise training, which is known to induce reverse remodelling, and if the training effect is attenuated in elderly HFREF patients. We therefore assessed DD in a cohort of referent controls (RCs) and HFREF patients and studied the response of DD to endurance exercise in two age groups (≤55 years and ≥65 years). METHODS AND RESULTS: Sixty RC (30 ≤ 55 years, mean age 50 ± 5 years; 30 ≥ 65 years, 72 ± 4 years) and 60 HFREF patients (30 ≤ 55 years, 46 ± 5 years; 30 ≥ 65 years, 72 ± 5 years, EF 28 ± 5%) were randomized to 4 weeks of supervised endurance training or to a control group. Exercise training was effective in reducing LV isovolumetric relaxation time by 29% in young and by 26% in old HFREF patients (P< 0.05 for both). As assessed by tissue Doppler, septal E' increased by 37% in young and by 39% among old HFREF patients (P< 0.005 for both) resulting in a significant decrease in the E/E' ratio from 13 ± 1 to 10 ± 1 in young and 14 ± 1 to 11 ± 1 in old HFREF patients (P< 0.05 for both). Serum levels of N-terminal pro brain natriuretic peptide were significantly reduced after endurance training in HFREF patients of all ages. CONCLUSION: In HFREF, diastolic function is significantly impaired in all age groups. Endurance training is highly effective in improving left ventricular diastolic function in HFREF patients regardless of age. This study is registered at ClinicalTrials.gov (number: NCT00176319). SN - 1522-9645 UR - https://www.unboundmedicine.com/medline/citation/22267243/Age_related_effects_of_exercise_training_on_diastolic_function_in_heart_failure_with_reduced_ejection_fraction:_the_Leipzig_Exercise_Intervention_in_Chronic_Heart_Failure_and_Aging__LEICA__Diastolic_Dysfunction_Study_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehr469 DB - PRIME DP - Unbound Medicine ER -