Hieda M, Sarma S, Hearon CM, et al. - Patients with left ventricular (LV) hypertrophy (LV septum >11 mm) and elevated cardiac biomarkers (stage B heart failure with preserved ejection fraction) showed reduction in LV myocardial stiffness after completing 1 year of exercise training. Hence, exercise training in such patients may induce protection against the future risk of heart failure with preserved ejection fraction.

• In this prospective, randomized controlled trial, a total of 46 patients with LV hypertrophy and elevated cardiac biomarkers were assigned to either 1 year of high-intensity exercise training (n = 30) or attention control (n = 16).

• Participants underwent right-heart catheterization and 3-dimensional echocardiography along with manipulation of preload using both lower body negative pressure and rapid saline infusion to determine the LV end-diastolic pressure-volume relationship.

• One year of exercise training increased max by 21% (baseline 26.0±5.3 to 1 year later 31.3±5.8 mL·min–1·kg–1), whereas controls showed no significant change in max (baseline 24.6±3.4 to 1 year later 24.2±4.1 mL·min–1·kg–1).

• A lowering in LV myocardial stiffness occurred (right and downward shift in the end-diastolic pressure-volume relationship; LV myocardial stiffness: baseline 0.062±0.020 to 1 year later 0.031±0.009), whereas controls showed no significant change (baseline 0.061±0.033 to 1 year later 0.066±0.031).