A new Scientific Statement released by the American Heart Association in partnership with the ACC highlights the importance of supervised exercise training for chronic, stable heart failure with preserved ejection fraction (HFpEF), and underscores the value of pursuing referral, adherence and coverage efforts.

The statement, led by Chair Vandana Sachdev, MD, and Vice Chair Kavita Sharma, MD, FACC, examines the currently available scientific evidence on the assessment and quantitation of exercise intolerance in HFpEF, mechanisms of exercise intolerance in this patient group, and benefits from exercise training.

It also provides a closer analysis of data from aerobic exercise training trials focused on patients with chronic HFpEF and compares current applications of exercise-based therapies for HFpEF with other cardiovascular conditions.

Additionally, the statement highlights existing gaps or barriers in exercise-based therapy implementation, including "exercise setting, training modalities, combinations with other strategies such as diet and medications, long-term adherence, incorporation of innovative and more accessible delivery methods, and management of recently hospitalized patients."

"Improved management of the large, inadequately treated population of patients with HFpEF represents an urgent unmet need," according to Sachdev, Sharma and colleagues, who note that current "trials of exercise-based interventions have consistently demonstrated large, significant, clinically meaningful improvements in symptoms, objectively determined exercise capacity, and usually quality of life.

They recommend that future research should focus on maximizing the benefits and accessibility of supervised exercise training, including extending its availability to medically supervised group, home-based, and hybrid cardiac rehabilitation settings, while also looking at common barriers to long-term adherence.