Novel Cardiac Rehabilitation in Patients Heart Failure and Preserved Ejection Fraction

Therapuetic Areas:Cardiology / Vascular Diseases
Age Range:50 - Any
Start Date:March 1, 2016
End Date:September 30, 2020
Contact:Crystal Grimshaw

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Patients with HFpEF suffer from exercise intolerance, increased risk for hospitalization and
mortality, and poor QOL. Unlike patients with HFrEF, no drug or device therapies appear to be
consistently beneficial in treating these problems. However, increasing evidence suggests
that exercise training is effective for both partially reversing exercise intolerance and
improving quality of life in these patients. Most such trials to date have been conducted in
controlled research setting, versus integrating these patients in to a standard CR program.
Also, since functional capacity is related to outcomes in these patients, exercise strategies
aimed at further improving fitness are warranted. One such strategy is using higher intensity
interval training (HIIT) in the CR setting, a strategy shown to be effective in patients with
other types of CVD. This project is designed to test the feasibility of incorporating these
patients into the CR setting, and training them using a methodology (i.e., HIIT) already
shown to yield (in other patients with CVD) greater gains in fitness when compared to what
was achieved using standard MCT alone.

Inclusion Criteria:

1. NYHA class II or III symptoms

2. Referred by physician to CR with echocardiographic evidence of HFpEF defined as an
ejection fraction ≥ 50 % and moderate to severe (grade II-III) diastolic dysfunction.

3. ≥ 50 years of age

4. Free of orthopedic or other medical problems that would limit participation in CR

5. Peak VO2 on baseline cardiopulmonary exercise test (CPX) < 24 mL/kg/min in men and <21
mL/kg/min in women

Exclusion Criteria:

1. Systolic dysfunction, per ejection fraction < 50%; those with mild (grade I) diastolic

2. Initial clinical responses observed during first 3 visits in CR or baseline exercise
test that would preclude participation in study over-all (e.g., new onset/troublesome
arrhythmia that warrants further investigation) or undergoing HIIT (e.g.,
claudication, balance issue)

3. Patients with exercise induced angina during CR or CPX testing or ST segment
depression representative of myocardial ischemia during CPX testing

4. Pregnant or planning to become pregnant

5. Any patient recently hospitalized for heart failure will have to wait at least 2 weeks
before starting CR, or until clinically stable per physician(whichever time period is

6. Atrial fibrillation
We found this trial at
2799 W Grand Blvd
Detroit, Michigan 48202
(313) 916-2600
Principal Investigator: Steven J Keteyian, PhD
Phone: 313-972-1815
Henry Ford Hospital Founded in 1915 by auto pioneer Henry Ford and now one of...
Detroit, MI
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