High Intensity Interval Exercise in Diastolic Heart Failure

Heart failure is a major health concern and is the leading cause of hospitalization among
elderly Americans. Currently 5.7 million Americans are estimated to have heart failure and
the estimated direct and indirect costs of treating heart failure are approximately $37.2
billion. Approximately 40% of those diagnosed with heart failure will have heart failure with
preserved ejection fraction (HFPEF). These individuals have significant restrictions in their
ability to carry out activities of daily living. Exercise training has been established as
adjuvant therapy in heart failure. Although exercise training guidelines for treatment of
heart failure with reduced ejection fraction (HFREF) are well established, no consensus
exercise guidelines exist for management of HFPEF. Aerobic and cardiovascular adaptations are
generally greater after high-intensity exercise training; interval-type exercise facilitates
this type of training because it allows for rest periods that make it possible for patients
with heart failure to perform short (e.g., 1-4 minutes) work periods at intensities that are
higher than would be possible during continuous exercise. High-intensity aerobic interval
training presents a unique, yet untested, therapeutic modality for the exercise training of
patients with heart failure with preserved ejection fraction. Pilot testing is warranted,
results of which may have important implications for reducing cardiovascular risk, increasing
short- and long-term quality of life and survival, and reducing healthcare costs in this
patient population. The investigators primary specific aim is to determine the efficacy of a
novel, high-intensity aerobic interval exercise training program for improving VO2peak (peak
oxygen uptake), endothelial function, and arterial stiffness in patients with HFPEF. The
investigators secondary aim is to determine whether the vascular changes are correlated with
the changes in VO2peak.