Resistance Training in HFpEF
Condition: Heart Failure Preserved Ejection Fraction
MeSH terms: Heart Failure
Study type: Interventional

Summary: 
      The objective of this proposal is to determine the effect of resistance exercise training on
      locomotor muscle function, exercise capacity, exertional symptoms, and quality of life in HF
      patients with preserved ejection fraction (HFpEF).
    

Detailed description: 
      In this randomized controlled pilot study of resistance exercise training in patients with
      HFpEF, the investigators will recruit 24 HFpEF patients who will be randomized to resistance
      exercise training (RT - n=12) or no resistance exercise training (standard care control group
      [CTL] - n=12). The investigators will have baseline and follow-up measures of clinical
      characteristics, leg muscle strength, quality of life, lean muscle mass (body composition via
      DXA including segmental lean mass), maximal cardiopulmonary exercise test (peak VO2, peak
      work, ventilatory efficiency), constant-load submaximal cardiopulmonary exercise test with
      speckle tracking echocardiography (exertional dyspnea and fatigue at matched workloads,
      cardiac output, diastolic function, left ventricular strain, ventilation, gas exchange, and
      locomotor muscle neural feedback).

      Participants will be asked to make 4 separate study visits. Those randomized to undergo
      Resistance Training will be expected to make those visits as well.
    

Intervention name(s): Resistance Exercise Training; DEXA bone scan; Cardiopulmonary Max Exercise Test; Quality of Life Questionnaire; Submaximal Exercise Test; Blood Draw
Intervention type(s): Other; Radiation; Other; Other; Other; Other
Intervention description(s): Aerobic Exercise
a. Each participant will engage in 5 minutes of aerobic based exercise on an arm/leg ergometer (NuStep Cross Trainer) at an intensity of 12-14 on the Borg Rating of Perceived Exertion Scale as a warm-up prior to the exercise session and again as a cool-down at the end of the exercise session.
Resistance Exercise - 2 sets of 8-12 repetitions - beginning at 60% of the initial 1 RM.
a) Leg Extension, b) Bicep Curl, c) Leg Press, d) Chest Press, e) Leg Curl, f)Seated Row (horizontal or pulldown), g) Calf Raises
Core Strengthening Exercises a. 5-10 minutes of stability ball and balance exercises; A DEXA scan that provides bone density measures.; Pedaling on a cycle ergometer to volitional fatigue.; A 10 minute questionnaire that measures quality of life.; Two short submaximal constant-load exercise sessions at 20 Watts. Each session will include 6 minutes of cycling (baseline). Following baseline, the sessions will be randomized to continued constant-load cycling for an additional 9 minutes (for echocardiographic measures) or randomized sub-systolic inflation of bilateral thigh pressure tourniquets to 40 and 80 mmHg for 3 minutes with 3 minutes of deflation between inflations to stimulate locomotor muscle neural feedback.; A blood draw amounting to 1 teaspoon of blood drawn.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Resistance Training; Exercise; Heart Failure preserved Ejection Fraction