Novel Cardiac Rehabilitation in Patients Heart Failure and Preserved Ejection Fraction

Inclusion Criteria:

1. NYHA class II or III symptoms

2. Referred by physician to CR with echocardiographic evidence of HFpEF defined as an
ejection fraction ≥ 50 % and moderate to severe (grade II-III) diastolic dysfunction.

3. ≥ 50 years of age

4. Free of orthopedic or other medical problems that would limit participation in CR

5. Peak VO2 on baseline cardiopulmonary exercise test (CPX) < 24 mL/kg/min in men and <21
mL/kg/min in women

Exclusion Criteria:

1. Systolic dysfunction, per ejection fraction < 50%; those with mild (grade I) diastolic
dysfunction

2. Initial clinical responses observed during first 3 visits in CR or baseline exercise
test that would preclude participation in study over-all (e.g., new onset/troublesome
arrhythmia that warrants further investigation) or undergoing HIIT (e.g.,
claudication, balance issue)

3. Patients with exercise induced angina during CR or CPX testing or ST segment
depression representative of myocardial ischemia during CPX testing

4. Pregnant or planning to become pregnant

5. Any patient recently hospitalized for heart failure will have to wait at least 2 weeks
before starting CR, or until clinically stable per physician(whichever time period is
greater)

6. Atrial fibrillation