Author + information
- Received September 25, 2018
- Accepted September 26, 2018
- Published online November 26, 2018.
- Ambarish Pandey, MD, MSCSa,
- Kershaw V. Patel, MDa,
- Muthiah Vaduganathan, MD, MPHb,
- Satyam Sarma, MDa,
- Mark J. Haykowsky, PhDc,
- Jarett D. Berry, MD, MSa,d and
- Carl J. Lavie, MDe,∗ ()
- aDivision of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- bBrigham and Women’s Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts
- cCollege of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas
- dDepartment of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
- eDepartment of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana
- ↵∗Address for correspondence:
Dr. Carl J. Lavie, Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, 1514 Jefferson Highway, New Orleans, Louisiana 70121.
Heart failure with preserved ejection fraction (HFpEF) is common, increasing in prevalence, and refractory to available pharmacotherapies. Our understanding of HFpEF has evolved from a disorder of diastolic dysfunction to a constellation of physiologic impairments that lead to elevated left ventricular filling pressures and exercise intolerance. Accordingly, the therapeutic and preventive focus has shifted to identifying lifestyle factors that may have more pleotropic effects on the pathophysiologic mechanisms that define HFpEF. Recent studies have demonstrated that physical inactivity, low fitness, and obesity are potential modifiable targets for prevention as well as management of HFpEF. In this review, we have discussed the emerging epidemiological, mechanistic, and clinical evidence that support the role of these lifestyle factors as key determinants of development and progression of HFpEF. We also summarize the available evidence and major knowledge gaps with regard to developing exercise training and weight loss as unique and effective therapeutic strategies for management of HFpEF.
Dr. Pandey is supported by the Texas Health Resources Clinical Scholars Program. Dr. Vaduganathan is supported by the KL2/Catalyst Medical Research Investigator Training award TR002542 from Harvard Catalyst/The Harvard Clinical and Translational Science Center; and is a consultant to Bayer AG and Baxter Healthcare. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received September 25, 2018.
- Accepted September 26, 2018.
- 2018 American College of Cardiology Foundation
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