Heart failure & cardiomyopathies
Effect of structured exercise training on chronotropic incompetence in patients with heart failure with preserved ejection fraction
Authors' conclusion
In elderly patients with HFpEF, neither HIIT nor MCT during 3 months significantly improved chronotropic reserve or reduced CI prevalence, but exercise capacity was improved.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) (66% female, mean age 70 ± 8 years)144 completed follow-up
- Participants
- 175 patients
- Comparison
- High-intensity interval training (HIIT) vs moderate continuous training (MCT) vs guideline control
- Primary endpoint
- Chronotropic reserve (chronotropic index, %predicted peak heart rate, CI prevalence)
- Follow-up
- 3 months
Primary result
As reported in the abstract
Chronotropic index, %predicted peak heart rate, CI prevalence
- HIIT and MCT did not improve chronotropic index, %predicted peak heart rate, nor CI prevalence
- all P > 0.500
Further findings
Baseline: chronotropic incompetence (CI) prevalence and association with exercise capacity (CI vs no CI)
- CI present
- 51%
- Peak oxygen uptake, CI vs no CI
- 16.5 ± 4.2 vs. 21.1 ± 5.2 mL/kg/min, P < 0.001
- Peak workload, CI vs no CI
- 89 ± 28 vs. 116 ± 39 W, P < 0.001
- Ventilatory efficiency, CI vs no CI
- 35.2 ± 7.1 vs. 32.6 ± 6.8, P = 0.014
V̇O2peak and workload · 3 months
- HIIT and MCT improved V̇O2peak and workload vs guideline control (GC), regardless of CI
- P < 0.001
Original publication
Effect of structured exercise training on chronotropic incompetence in patients with heart failure with preserved ejection fraction. Eur J Prev Cardiol. Published 30 September 2025. doi:10.
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