The Index of Exercise Tolerance in Heart Failure with Preserved Ejection Fraction is Gait Speed

Exercise tolerance, an important factor affecting life prognosis and rehospitalization in patients with chronic heart failure, is a major outcome of cardiac rehabilitation. Heart failure with preserved ejection fraction (HFpEF) from reduced diastolic capacity has recently increased among patients with chronic heart failure. This study evaluated and clarified the factors indicating exercise tolerance in patients with HFpEF from various perspectives, including cardiac and skeletal muscle functions.

The subjects were 31 patients with HFpEF who underwent cardiac rehabilitation. Exercise tolerance was assessed using a 6-minute walking test. Physical function, physical activity, body composition test, baseline characteristics, blood data, and echocardiography results were extracted from medical records to identify the indicators of exercise tolerance.

Gait speed was significantly different in exercise tolerance for HFpEF patients (β=0.75, p<0.01). Unlike HFrEF, HFpEF were no significant differences in brain natriuretic peptide (BNP) levels and cardiac function.

Gait speed is an indicator of exercise tolerance in HFpEF patients. However, its pathological course differs from HFrEF, indicating that it is poorly related to BNP, a biomarker for heart failure and cardiac function.