From the Guidelines
Aerobic exercise is the best type to improve ejection fraction, particularly moderate-intensity activities like walking, swimming, cycling, or using an elliptical machine for 30 minutes most days of the week. This is based on the most recent and highest quality study available, which highlights the benefits of exercise in improving symptoms, exercise capacity, and quality of life in patients with heart failure 1.
When starting an exercise program, it's essential to begin with shorter sessions of 5-10 minutes and gradually build up to the recommended 150 minutes per week. The intensity should be moderate, where you can talk but not sing, and resistance training with light weights can be added 2-3 times weekly, focusing on multiple muscle groups with 10-15 repetitions per exercise.
These exercises improve ejection fraction by:
- Strengthening the heart muscle
- Enhancing its pumping efficiency
- Reducing peripheral resistance
- Improving overall cardiovascular function
The heart adapts to regular exercise by becoming more efficient at pumping blood, which directly improves ejection fraction over time. It's crucial to consult your cardiologist before starting any exercise program, especially if you have heart failure or a reduced ejection fraction, as they can provide personalized recommendations based on your specific cardiac condition and health status 1.
Some key points to consider when exercising with heart failure include:
- Starting at a low to moderate level (25% to 60% of V˙ O2 max) of exercise capacity
- Careful supervision and monitoring, particularly during the initial training period
- Telemetry monitoring during early sessions
- Gradually increasing duration and intensity of activity as endurance improves
- Considering resistance training, but ensuring safety and efficacy are established 1.
Overall, a well-structured exercise program can significantly improve ejection fraction, symptoms, and quality of life in patients with heart failure, and should be a crucial component of a comprehensive treatment plan.
From the Research
Exercise and Ejection Fraction
- The best exercise to improve ejection fraction is a topic of ongoing research, with various studies investigating the effects of different exercise modalities on left ventricular ejection fraction (LVEF) in patients with heart failure with reduced ejection fraction (HFrEF) 2.
- Moderate-intensity continuous training (MICT) has been shown to significantly increase LVEF, with the greatest benefits occurring with long-term (≥6 months) training 2.
- High-intensity interval training (HIIT) has also been found to significantly increase LVEF, although its effects are not different from those of MICT 2.
- Resistance training, on the other hand, has not been shown to significantly change LVEF when performed alone or combined with aerobic training 2.
Key Findings
- A meta-analysis of exercise training on LVEF in HFrEF patients found that MICT and HIIT can improve LVEF, with MICT being the most effective therapy for attenuating left ventricular remodeling 2.
- The benefits of exercise training on aerobic capacity in patients with heart failure and preserved ejection fraction (HFpEF) have also been demonstrated, with exercise training programs helping to restore physiological function and improve quality of life 3.