Targeted Temperature Management after Cardiac Arrest

ventions are primarily due to improved skeletal muscle function. 3 We agree with Brunner regarding heterogeneity of the patients with heart failure in our trial.Notably, patients with preserved ejection fraction and those with reduced ejection fraction were included in the trial.We recently reported that among these two phenotypes, the participants with heart failure with preserved ejection fraction had significantly worse physical dysfunction and frailty at baseline and appeared to receive much greater benefit from the intervention, including benefit in terms of improved physical functioning and quality of life and lower rates of frailty, rehospitalization, and death. 4 Although the outcomes in our trial are clinically meaningful, we agree that a larger trial, adequately powered for clinical events and safety, will be needed to effect change in clinical practice and reimbursement.Ideally, such a trial would focus on patients with heart failure with preserved ejection fraction, given their worse baseline status, greater response to the intervention, and limited treatment options as compared with those with heart failure with reduced ejection fraction.