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EX-DHF

Trial question
What is the effect of combined endurance and resistance training in patients with HFpEF?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
60.0% female
40.0% male
N = 322
322 patients (192 female, 130 male).
Inclusion criteria: patients with HFpEF.
Key exclusion criteria: non-cardiac causes for HF; significant coronary artery disease; any inability or contraindication to participate in ergospirometric testing or in an exercise program; ineffective control or resting BP; expected low compliance.
Interventions
N=161 exercise training (endurance and resistance training on 3 days/week for 12 months and advice to increase leisure time physical activity).
N=161 usual care (no tailored exercise prescription, supervised training or structured advice to increase daily physical activities).
Primary outcome
Improvement in modified Packer score at 12 months
20.5%
8.1%
20.5 %
15.4 %
10.3 %
5.1 %
0.0 %
Exercise training
Usual care
No significant difference ↔
No significant difference in improvement in modified Packer score at 12 months (20.5% vs. 8.1%; AD 12.4%, 95% CI -5.28 to 30.08).
Safety outcomes
No significant differences in all-cause hospitalizations, cardiovascular hospitalizations.
Conclusion
In patients with HFpEF, exercise training was not superior to usual care with respect to improvement in modified Packer score at 12 months.
Reference
Frank Edelmann, Rolf Wachter, André Duvinage et al. Combined endurance and resistance exercise training in heart failure with preserved ejection fraction: a randomized controlled trial. Nat Med. 2025 Jan 2. Online ahead of print.
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