Low Fitness in Midlife: A Novel Therapeutic Target for Heart Failure with Preserved Ejection Fraction Prevention

Ambarish Pandey; Douglas Darden; Jarett D Berry

doi:10.1016/j.pcad.2015.05.007

Low Fitness in Midlife: A Novel Therapeutic Target for Heart Failure with Preserved Ejection Fraction Prevention

Prog Cardiovasc Dis. 2015 Jul-Aug;58(1):87-93. doi: 10.1016/j.pcad.2015.05.007. Epub 2015 May 13.

Authors

Ambarish Pandey¹, Douglas Darden², Jarett D Berry³

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
² Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
³ Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: jarett.berry@utsouthwestern.edu.

PMID: 25982216
DOI: 10.1016/j.pcad.2015.05.007

Abstract

Heart failure (HF) with preserved ejection fraction (HFpEF) is common and recalcitrant to any medical therapy, highlighting the need for novel strategies focused on its prevention. Recent studies have shown that low cardiorespiratory fitness (CRF) in middle age identifies a subgroup of individuals at particularly high risk for HF, particularly HFpEF. These findings suggest that low CRF in middle age represents an upstream marker for late-life HFpEF. Furthermore, evidence from recent epidemiological studies suggests that low CRF associated risk for HFpEF appears to be modifiable with improvement in CRF. The primary objective of this review is to provide an overview of the potential mechanisms through which exercise training and improvement in CRF may protect against the transition from a low fit stage to clinical HFpEF among at-risk sedentary, middle-age adults.

Keywords: Cardiorespiratory fitness; Exercise training; Heart failure with preserved ejection fraction.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Age Factors
Aging*
Heart Failure / diagnosis
Heart Failure / epidemiology
Heart Failure / physiopathology
Heart Failure / prevention & control*
Humans
Middle Aged
Physical Fitness*
Preventive Health Services / methods*
Prognosis
Protective Factors
Risk Assessment
Risk Factors
Risk Reduction Behavior*
Sedentary Behavior*
Stroke Volume*
Ventricular Function, Left*