Exercise Intolerance in Older Adults With Heart Failure With Preserved Ejection Fraction: JACC State-of-the-Art Review.

Journal Article (Journal Article;Review)

Exercise intolerance (EI) is the primary manifestation of chronic heart failure with preserved ejection fraction (HFpEF), the most common form of heart failure among older individuals. The recent recognition that HFpEF is likely a systemic, multiorgan disorder that shares characteristics with other common, difficult-to-treat, aging-related disorders suggests that novel insights may be gained from combining knowledge and concepts from aging and cardiovascular disease disciplines. This state-of-the-art review is based on the outcomes of a National Institute of Aging-sponsored working group meeting on aging and EI in HFpEF. We discuss aging-related and extracardiac contributors to EI in HFpEF and provide the rationale for a transdisciplinary, "gero-centric" approach to advance our understanding of EI in HFpEF and identify promising new therapeutic targets. We also provide a framework for prioritizing future research, including developing a uniform, comprehensive approach to phenotypic characterization of HFpEF, elucidating key geroscience targets for treatment, and conducting proof-of-concept trials to modify these targets.

Full Text

Duke Authors

Cited Authors

  • Pandey, A; Shah, SJ; Butler, J; Kellogg, DL; Lewis, GD; Forman, DE; Mentz, RJ; Borlaug, BA; Simon, MA; Chirinos, JA; Fielding, RA; Volpi, E; Molina, AJA; Haykowsky, MJ; Sam, F; Goodpaster, BH; Bertoni, AG; Justice, JN; White, JP; Ding, J; Hummel, SL; LeBrasseur, NK; Taffet, GE; Pipinos, II; Kitzman, D

Published Date

  • September 14, 2021

Published In

Volume / Issue

  • 78 / 11

Start / End Page

  • 1166 - 1187

PubMed ID

  • 34503685

Pubmed Central ID

  • PMC8525886

Electronic International Standard Serial Number (EISSN)

  • 1558-3597

Digital Object Identifier (DOI)

  • 10.1016/j.jacc.2021.07.014


  • eng

Conference Location

  • United States