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Heart Failure with Preserved Ejection Fraction as an Exercise Deficiency Syndrome: JACC Focus Seminar (JACC September 2022-2)

Across differing spectrums of cardiac function and cardiac pathologies, there are strong associations between measures of cardiorespiratory fitness and burden of symptoms, quality of life, and prognosis. In this part 2 of a 4-part series, we contend that there is a strong association among physical activity, cardiorespiratory fitness, and cardiac function. We argue that a chronic lack of exercise is a major risk factor for heart failure with preserved ejection fraction in some patients. In support of this hypothesis, increasing physical activity is associated with greater cardiac mass, greater stroke volumes, greater cardiac output and peak oxygen consumption, and fewer clinical events. Conversely, physical inactivity results in cardiac atrophy, reduced output, reduced chamber size, and decreased ability to augment cardiac performance with exercise. Moreover, physical inactivity is a strong predictor of heart failure risk and death. In sum, exercise deficiency should be considered part of the broad heart failure with preserved ejection fraction phenotype.


Valentin Fuster, MD, PhD, MACC

CME Editor
Ragavendra R. Baliga, MD

Andre La Gerche, MBBS, PhD

Important Dates

Date of Release: September 12, 2022
Term of Approval/Date of CME/MOC/ECME Expiration: September 11, 2023

Availability: On-Demand
Expires on Sep 11, 2023
Cost: FREE
Credit Offered:
1 CME Credit
1 ABIM-MOC Point
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