{"id":"d735e5d096d5","type":"article","url":"https://hartvaat.nl/2025/06/01/trainingseffect-op-diastolische-functie-bij-hfpef/","title":"Trainingseffect op diastolische functie bij HFpEF","title_en":"Training-induced change of diastolic function in heart failure with preserved ejection fraction.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["hfpef","step-hfpef"],"journal":"ESC heart failure","doi":"10.1002/ehf2.15225","source_url":"https://doi.org/10.1002/ehf2.15225","authors":["Andreas B Gevaert","Ephraim B Winzer","Stephan Mueller","Stephanie De Schutter","Paul J Beckers","Jennifer Hommel","Axel Linke","Ulrik Wisløff","Volker Adams","Burkert Pieske","Martin Halle","Emeline M Van Craenenbroeck","Caroline M Van De Heyning"],"significance":5,"published":"2025-06-01","source_date":"2025-06-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/diastolische-disfunctie-mechanisme/","https://hartvaat.nl/kennis/hartfalen/echocardiografie-bij-hartfalen/"],"congress":"","summary_en":"A substudy of the OptimEx-Clin trial investigated whether exercise training improves diastolic function during exercise in HFpEF patients. Training improved the E/e’ ratio and diastolic filling, providing mechanistic insight into the exercise capacity benefit in HFpEF.","created":"2026-07-03T10:31:39Z","updated":"2026-07-03T13:30:39Z","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":"Studie onderzocht de verandering in diastolische functie door inspanningstraining bij HFpEF. Training verbeterde de E/e' ratio en de diastolische vulling, wat het mechanisme achter het inspanningsvoordeel bij HFpEF verklaart.","abstract_original":"AIMS: Exercise training improves aerobic capacity (V̇O2peak) in patients with heart failure and preserved ejection fraction (HFpEF), but underlying mechanisms remain unclear. We aimed to evaluate whether exercise training could improve systolic and diastolic function during exercise. METHODS: This was a substudy of the multicentre Optimizing Exercise Training in HFpEF (OptimEx-Clin) trial, in which 180 patients with HFpEF were randomized 1:1:1 to guideline control, moderate continuous training or high-intensity interval training. All patients included at two out of five participating sites underwent exercise echocardiography at baseline and 3 months. Patients of both training groups were pooled and compared with guideline control. RESULTS: A total of 61 patients (mean age 73 ± 7 years, 72% female) were included. At baseline, E/e' increased from 17.0 ± 5.7 to 19.5 ± 6.1 and systolic pulmonary artery pressure from 31 ± 8 to 51 ± 11 mmHg (both P < 0.001). Right ventricular function did not change significantly (maximal tricuspid annular plane systolic excursion 24.7 ± 4.0 mm, P = 0.051 vs. baseline). At 3 months, patients randomized to exercise training improved V̇O2peak (control +0.2, training +2.7 mL/kg/min, P = 0.006) and demonstrated small but significant improvements in exercise E/e' (control 21.7 ± 7.5 to 22.8 ± 9.2, training 18.3 ± 5.0 to 17.2 ± 4.1, P = 0.044). No significant changes were observed in ejection fraction, mitral or tricuspid annular plane systolic excursion, S', A' or systolic pulmonary artery pressure (P > 0.05). Changes in E/e' were not associated with the change in V̇O2peak. CONCLUSIONS: In patients with HFpEF, exercise echocardiography revealed increases in filling pressures as well as a failure to augment right ventricular function during exercise. After 3 months of exercise training, HFpEF patients demonstrated a small improvement in diastolic function (exercise E/e'), but this did not explain the improved aerobic capacity."}