Item Details

abstract

Exercise intolerance is considered the hallmark symptom of heart failure with preserved ejection fraction (HFpEF). One factor that possibly contributes to exercise intolerance is an inadequate heart rate response, also known as chronotropic incompetence (CI). Chronotropic incompetence is potentially manageable with medications, rate-adaptive pacing, and lifestyle interventions such as aerobic exercise training (ET) and/or caloric restriction (CR). The purpose of this thesis was to determine the prevalence of CI in a HFpEF population and examine the effects of a 20-week ET, CR diet, or their combination, to manage CI and improve HR responses in HFpEF patients. Data from the Study Examining Caloric Restriction and Exercise Training (SECRET I Trial) was used for this analysis. It was hypothesized that the prevalence of CI in the SECRET I participants will not be significantly different from the estimates of CI in the HFpEF population. It was also hypothesized that ET, CR, or ET + CR will improve HR responses. Participants had typical clinical features of HFpEF: 67 + 5 years, 81% female, and obese BMI. The prevalence of CI in SECRET I was 41%. There was a significant main effect from baseline to 20-weeks for HRrest, HRsubmaximal, and HRrecovery. There was a significant correlation between the change in HRreserve and change in relative VO2peak (r= 0.400, p-0.001), change in HRreserve and change in absolute VO2peak (r = 0.374, p-0.001), and the change in body weight to change in HRreserve (r= -0.288, p-0.016). Caloric restriction and ET together produced a larger, albeit non-significant, decrease in the prevalence of CI. This study suggests that ET and/or CR can improve the HR response of older, obese, patients with HFpEF but appears to have limited impact on reversing CI in these patients

subject

Caloric Restriction

Chronotropic Incompetence

Exercise

Heart Failure

HFpEF

contributor

Bennett, Emerson Elizabeth (author)

Brubaker, Peter H (committee chair)

Berry, Michael J (committee member)

Miller, Gary D (committee member)

date

2022-05-24T08:35:57Z (accessioned)

2023-05-23T08:30:15Z (available)

2022 (issued)

degree

Health and Exercise Science (discipline)

embargo

2023-05-23 (terms)

identifier

http://hdl.handle.net/10339/100731 (uri)

language

en (iso)

publisher

Wake Forest University

title

IMPACT OF EXERCISE TRAINING AND/OR CALORIC RESTRICTION ON HEART RATE RESPONSE IN PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION

type

Thesis