{"id":"de8d4e737382","type":"article","url":"https://hartvaat.nl/2018/04/10/sedentaire-veroudering-omkeren-op-middelbare-leeftijd-gerandomiseerde-trial-voor/","title":"Sedentaire veroudering omkeren op middelbare leeftijd: gerandomiseerde trial voor HF-preventie","title_en":"Reversing the Cardiac Effects of Sedentary Aging in Middle Age-A Randomized Controlled Trial: Implications For Heart Failure Prevention.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts"],"tags":["finearts-hf","hartrevalidatie","primaire-preventie","select-trial","step-hfpef","stride-trial","summit-trial"],"journal":"Circulation","doi":"10.1161/CIRCULATIONAHA.117.030617","source_url":"https://doi.org/10.1161/CIRCULATIONAHA.117.030617","authors":["Erin J Howden","Satyam Sarma","Justin S Lawley","Mildred Opondo","William Cornwell","Douglas Stoller","Marcus A Urey","Beverley Adams-Huet","Benjamin D Levine"],"significance":8,"published":"2018-04-10","source_date":"2018-04-10","image":"","kennis":[],"congress":"","summary_en":"This randomized trial showed that a 2-year intensive exercise program in sedentary middle-aged adults reversed the cardiac stiffening associated with aging, with implications for preventing HFpEF. The study demonstrated a modifiable window for cardiovascular fitness intervention.","created":"2026-07-03T10:27:14Z","updated":"2026-07-03T13:26:29Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde trial die aantoonde dat een 2-jarig intensief trainingsprogramma op middelbare leeftijd de cardiale effecten van sedentaire veroudering kan omkeren. Implicaties voor HF-preventie.","abstract_original":"BACKGROUND: Poor fitness in middle age is a risk factor for heart failure, particularly heart failure with a preserved ejection fraction. The development of heart failure with a preserved ejection fraction is likely mediated through increased left ventricular (LV) stiffness, a consequence of sedentary aging. In a prospective, parallel group, randomized controlled trial, we examined the effect of 2 years of supervised high-intensity exercise training on LV stiffness. METHODS: Sixty-one (48% male) healthy, sedentary, middle-aged participants (53±5 years) were randomly assigned to either 2 years of exercise training (n=34) or attention control (control; n=27). Right heart catheterization and 3-dimensional echocardiography were performed with preload manipulations to define LV end-diastolic pressure-volume relationships and Frank-Starling curves. LV stiffness was calculated by curve fit of the diastolic pressure-volume curve. Maximal oxygen uptake (Vo2max) was measured to quantify changes in fitness. RESULTS: Fifty-three participants completed the study. Adherence to prescribed exercise sessions was 88±11%. Vo2max increased by 18% (exercise training: pre 29.0±4.8 to post 34.4±6.4; control: pre 29.5±5.3 to post 28.7±5.4, group×time P<0.001) and LV stiffness was reduced (right/downward shift in the end-diastolic pressure-volume relationships; preexercise training stiffness constant 0.072±0.037 to postexercise training 0.051±0.0268, P=0.0018), whereas there was no change in controls (group×time P<0.001; pre stiffness constant 0.0635±0.026 to post 0.062±0.031, P=0.83). Exercise increased LV end-diastolic volume (group×time P<0.001), whereas pulmonary capillary wedge pressure was unchanged, providing greater stroke volume for any given filling pressure (loading×group×time P=0.007). CONCLUSIONS: In previously sedentary healthy middle-aged adults, 2 years of exercise training improved maximal oxygen uptake and decreased cardiac stiffness. Regular exercise training may provide protection against the future risk of heart failure with a preserved ejection fraction by preventing the increase in cardiac stiffness attributable to sedentary aging. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02039154."}