Can aerobic exercise reverse loss of left ventricular compliance in early (Stage B ) heart failure with preserved ejection fraction (HFpEF)? Stage B HF is asymptomatic with increased in either natriuretic hormone or troponin with structural changes, i.e increased wall thickness indicating Left ventricular hypertrophy (LVH).Stage B heart failure is defined by ACC/AHA guidelines as having structural heart disease but no current or prior symptoms of HF.
Do we have another possibly ground breaking research paper from Dr. Ben Levine from the Institute for Exercise and Environmental Medicine In Dallas . In earlier publications Levine has demonstrated that long time endurance exercise can preserve at least to some important degree left ventricular compliance.
It is well established that normal sedentary aging leads increased stiffness of the left ventricle and Levine has shown that this stiffness can be mitigated by long time endurance exercise and that LV compliance can be improved by an exercise program instituted even in early middle age.However by late middle age ( i.e past age 65) it is too late to reverse the stiffness.
In patients with LV hypertrophy and elevated cardiac markers Levine was able to show that one year of committed exercise training ( which included some high intensity interval training) was able to increase 02 Max and decrease left ventricular stiffness.
1)Hieda,M et al One-year committed exercise training reverses abnormal left ventricular myocardial stiffness in patients with Stage B heart failure with preserved ejection fraction.Circulation 2021;144, 934 -946 September 21 2021 full text is available
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