The Study
Combined endurance and resistance exercise training in heart failure with preserved ejection fraction: a randomized controlled trial
This study was a big experiment where patients were randomly put into two groups: one got exercise classes and the other got regular care. Since they were randomly assigned, if we see a difference, we can say the exercise caused it. The experiment found that exercise didn't make a big overall heart failure score better, but it did help people feel better and be able to do more exercise. So we can say exercise can improve fitness and symptoms, but we can't say it fixes the whole heart problem.
Analysis score
Maximum 90 for a randomized controlled trial.
Where the score came from
Researchers studied 322 people with heart failure with preserved ejection fraction (a type of heart failure where the heart pumps normally but is stiff). Half did a mix of cardio and strength training for a year, the other half got usual care. The study looked at a combined score of health outcomes. The overall score didn't show a clear benefit from exercise, but exercise did help with exercise ability and heart failure symptoms.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 590 / 100
Quality score
Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.
Key takeaways
Summary
Based on the study abstract and findings.
- 1The improvement in exercise capacity is considered meaningful for patients, potentially improving daily function.
- 2The lack of effect on the main composite score means the evidence is mixed, but exercise seems safe and beneficial for some important measures.
- 3Exercise training improved the distance/oxygen use by about 1.3 ml/kg/min more than usual care, and people were 7.77 times more likely to have an improved heart failure symptom class.
- 4However, the main composite score was not significantly different.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Nature Medicine
Year
2025
Authors
F. Edelmann, R. Wachter, A. Duvinage, S. Mueller, I. Fegers-Wustrow, S. Schwarz, J. Christle, E. Pieske‐Kraigher, Melchior Seyfarth, M. Knapp, Marcus Dörr, Kathleen Nolte, H. Düngen, C. Herrmann-Lingen, Katrin Esefeld, A. Hagendorff, M. Haykowsky, Gerd Hasenfuss, V. Holzendorf, C. Prettin, M. Mende, B. Pieske, Martin Halle
Related Content
Claims (10)
A year-long program combining endurance and strength training did not significantly improve a composite measure of health outcomes, including death, hospitalization, and everyday functioning, in people with a specific type of heart failure (HFpEF) compared with standard care.
For people with heart failure with preserved ejection fraction (HFpEF), a 12-month program of both endurance and resistance exercise improves heart failure symptoms more than usual care, with 7.77 times higher odds of improvement.
For stable patients with heart failure with preserved ejection fraction, a supervised 12-month exercise program that combines endurance and resistance training is safe, causing no heart attacks or strokes during exercise sessions. However, these patients were hospitalized for heart failure or exercise-related reasons more often than patients receiving usual care.
A 12-month program of combined endurance and resistance exercise does not significantly delay death from any cause or reduce heart-related hospitalizations in patients with heart failure with preserved ejection fraction, compared with standard care.
For people with heart failure with a preserved ejection fraction, a 12-month exercise program that includes both endurance and resistance training improves cardiorespiratory fitness, raising peak oxygen consumption by an average of 1.3 ml/kg/min compared with standard care.
A year-long program of endurance and resistance exercise does not significantly improve a combined heart failure outcome score in patients with heart failure with preserved ejection fraction compared to standard care. The score tracks death, hospitalizations, and changes in exercise capacity and heart function.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.