Mechanisms of Impaired Skeletal Muscle Blood Flow and Exercise Intolerance in Veterans With Heart Failure With Preserved Ejection Fraction: Efficacy of Knee Extensor Training
VA Office of Research and Development
Summary
Heart failure with preserved ejection (HFpEF) disproportionately affects Veterans and is the number one reason for hospital discharge in the VA Health Care System. Exercise intolerance is a common complication experienced by patients with HFpEF, perpetuating physical inactivity and accelerating disease progression. This research proposal aims to elucidate mechanisms responsible for inadequate skeletal muscle blood flow and exercise intolerance in patients with HFpEF compared with healthy controls as well as following 8 weeks of exercise training in patients with HFpEF only.
Description
Heart failure (HF) with preserved ejection fraction (HFpEF) disproportionately afflicts Veterans and is the leading cause of hospitalization and mortality within the VA Health Care System. One chief symptom of HFpEF is severe exercise intolerance, an important predictor of quality of life, functional capacity, and mortality. In these patients, severe exercise intolerance is attributable to a disease-related loss of "peripheral vascular control," as evidenced by a marked attenuation in exercising skeletal muscle blood flow. Loss of peripheral vascular control is manifested as dysfunctions of th…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Age 18 years or older and able to give written informed consent * New York Heart Association (NYHA) functional class II or III * Left Ventricular Ejection Fraction (LVEF) \> 50% * Plasma Brain Natriuretic Peptide (BNP) \>200 pg/mL or NT-proBNP 400 pg/mL at enrollment Exclusion Criteria: * Prior EF of \<50%. * NYHA Class IV or HF that cannot be stabilized on optimized pharmacotherapy * Acute coronary syndrome, infiltrative cardiomyopathy, or myocarditis * Patients with HFpEF secondary to significant uncorrected primary valvular disease (except mitral regurgitation secon…
Interventions
- OtherExercise training
Patients with HFpEF will undergo 8 weeks of exercise training.
Location
- VA Salt Lake City Health Care System, Salt Lake City, UTSalt Lake City, Utah