Role of Exercise in Diastolic Heart Failure

Study Overview
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Brief Summary
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Diastolic heart failure is now being recognized as a key form of heart failure in older people. The focus of this research is to study ways to improve and maintain physical activity and functioning. This knowledge may improve the health and well-being in people with diastolic heart failure.

Detailed Description
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The purpose of this project is to better understand how endurance and fatigue relate to performing daily activities and how we might better improve endurance and reduce fatigue through an exercise program.

Official Title
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Relationship of Cardiovascular and Muscular Capacity to Daily Functioning in Frail Older Adults

Conditions
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Diastolic Heart Failure, Heart Failure With Preserved Ejection Fraction

Intervention / Treatment
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* Behavioral: Functional circuit training and lifestyle counseling
* Behavioral: Health education and independent walking


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 60 and over Evidence of diastolic dysfunction on echocardiogram Normal Left Ventricular Function (LVEF≥50%) Heart Failure-NYHA Class II/III Able and willing to participate in exercise program Able to come to Ann Arbor Michigan for testing Exclusion Criteria: Regularly exercising(30 minute per day, 3 times per week) Orthopedic or musculoskeletal condition that limits weight bearing Uncontrolled atrial fibrillation History of heart valve replacement Unstable or serious medical condition (ie. on dialysis, oxygen; severe anemia, uncontrolled blood pressure or coronary artery disease)

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Functional circuit training and lifestyle counseling<br> | Behavioral: Functional circuit training and lifestyle counseling<br>* Tests are performed at the beginning, and repeated after 12 and 24 weeks: Measure general fitness levels such as walking, strength and balance. Walk on a treadmill to measure your maximum fitness while wearing a mask to analyze your oxygen use. Blood and urine tests and a heart ultrasound. Questionnaires & activity measures. Group assignment for 12 weeks: -Exercise classes & activity guidance: Twice-weekly class that focuses on exercises that are similar to daily activities, such as walking and carrying objects. Obtain customized information and education to help you exercise and follow a low salt diet. Follow-up: -Monthly phone calls during the 12 week follow up period.<br>|
| Active Comparator: Health education and independent walking<br> | Behavioral: Health education and independent walking<br>* Tests are performed at the beginning, and repeated after 12 and 24 weeks. Measure general fitness levels such as walking, strength and balance. Walk on a treadmill to measure your maximum fitness while wearing a mask to analyze your oxygen use. Blood and urine tests and a heart ultrasound. Questionnaires & activity measures. Group assignment for 12 weeks: -Health education and walking: Weekly health education classes covering general topics related to heart failure, like medications, diet and exercise. Receive a pedometer for an at-home walking program. Follow-up: -No follow up support<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 6 minute walk |  | Baseline, 12 weeks, 24 weeks |