BACKGROUND: Diastolic heart failure (DHF) is common in older women. There have been no clinical trials that have identified therapies to improve symptoms in these patients. A total of 32 women with New York Heart Association class II and III DHF (left ventricular ejection fraction > 45% and symptoms of dyspnea or fatigue) were randomized into a 12-week home-based, low-to-moderate intensity (40% and 60%, respectively) exercise and education program (intervention) or education only program (control). METHODS AND RESULTS: The intervention group improved in the 6-minute walk test from 840 +/- 366 ft to 1043 +/- 317 ft versus 824 +/- 367 ft to 732 +/- 408 ft in the control group (p = 0.002). Quality of life also improved in the intervention group compared with the control group as measured by the Living with Heart Failure Questionnaire (41 +/- 26 to 24 +/- 18 versus 27 +/- 18 to 28 +/- 22 at 12 weeks, p = 0.002; 24 +/- 18 to 19 +/- 18 versus 28 +/- 22 to 32 +/- 27 at the 3-month follow-up, p = 0.014) and the Geriatric Depression Scale (6 +/- 4 to 4 +/- 4 versus 5 +/- 3 to 7 +/- 5 at 12 weeks, p = 0.012; 4 +/- 4 to 4 +/- 4 versus 7 +/- 5 to 7 +/- 5 at the 3-month follow-up, p = 0.009). CONCLUSIONS: Women with DHF exhibit significant comorbidities and physical limitations. Home-based, low-to-moderate intensity exercise, in addition to education, is an effective strategy for improving the functional capacity and quality of life in women with DHF. Further study is needed to assess the long-term effect of exercise on clinical outcomes.

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