University of Texas Southwestern Medical Center
Heart failure with preserved ejection fraction (HFpEF) is associated with a high morbidity and mortality burden. There are limited pharmacological options available for the treatment of HFpEF. Exercise intolerance (EI) is the cardinal symptom of HFpEF, which manifests as dyspnea and fatigue. EI leads to functional deconditioning and reduced quality of life (QOL), both of which elevate risk of death and hospitalization in patients with HFpEF. Supervised exercised training is associated with improvements in exercise capacity and QOL in adults with HFpEF. However, supervised exercise has not been widely utilized for the treatment of HFpEF due to logistical and fiscal barriers. This study will investigate the effects of a remote exercise training intervention on exercise capacity and skeletal muscle composition in patients with HFpEF, or those at risk for it. In addition, it will compare four different lifestyle interventions for their effects on exercise capacity.
Heart failure (HF) portends substantial morbidity, mortality, and health care costs in the United States and the prevalence of heart failure with preserved ejection fraction (HFpEF) relative to HF with reduced ejection fraction (HFrEF) has been increasing. HFpEF is associated with a high morbidity and mortality burden. There are limited pharmacological options available for the treatment of HFpEF. It is now recognized as a systemic, multi-organ, geriatric syndrome, with exercise intolerance (EI) and functional impairment as the key clinical manifestations. EI leads to functional deconditioning…
Inclusion Criteria: 1. Age\>= 18 yrs 2. LVEF (Left Ventricular Ejection Fraction) \>= 50% 3. History of HFpEF or at risk of HFpEF 1. HFpEF diagnosis based on:- -HF hospitalization within 12 months- * NT-proBNP \>360 pg/mL 2. Risk of HFpEF based on:- * \>2 risk factors (h/o diabetes, hypertension, obesity, physical inactivity by self-report) 4. SPPB \< 10 or VO2\<60th percentile 5. BMI \>=28 (for randomization in phase II) 6. Able to use cell phone and mobile application Exclusion Criteria: 1. Hospitalization 1 month prior to baseline visit 2. History of recurrent falls…
Tailored moderate-intensity exercise training video with weekly virtual meetings with a coach
Resistance training videos assigned to patient
Initiation/intensification of weight loss medications, such as semaglutide or tirzepatide
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