Physical activity and heart failure of preserved left ventricular ejection fraction

Heart failure with preserved left ventricular ejection fraction (HFpEF) is a clinical syndrome in which the structure and the function of the heart are damaged, with stiffness of the heart muscle, increased pressures in diastole and in the pulmonary circulation. The latest understanding of HFpEF is that it is a systemic disease of the microcirculation with chronic inflammation and impaired cellular metabolism. The aim of this review was to determine the association between physical activity and HFpEF based on the available research. By summarizing the literature data, it was shown that a sedentary lifestyle represents a risk factor for HFpEF and that continuous physical activity prevents the occurrence of HFpEF, while in patients already suffering from HFpEF it increases functional capacity, as well as the quality of life, mainly due to the improvement of peripheral muscles oxidative metabolism. The impact of physical activity on improving the diastolic function of the heart in people with heart failure is still under research. Patients with HFpEF usually have poor exercise tolerance, thus an individualized prescription of physical activity is indicated in accordance with their capabilities, preferably a combination of aerobic training, strength exercises, balance and an adequate diet. The gold standard for the assessment of aerobic capacity is the cardiopulmonary exercise test, which allows the measurement of oxygen consumption, maximum heart rate, the first and the second anaerobic thresholds, parameters needed for dosing the intensity of physical exercise.