A program of aerobic exercise canimprove the symptoms of diastolic dysfunctionand enhance the quality of life.
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Overview
The beating of the heart is divided into two phases—the beating phase (when the heart muscle contracts and ejects blood into the arteries), and the relaxation phase (when the heart fills with blood to prepare for the next heartbeat). The beating phase is calledsystole, and the relaxation phase is called diastole.
In diastolic dysfunction, a stiffening of the heart muscle affects the diastolic phase of the heartbeat, making it more difficult for the relaxing heart muscle to completely fill with blood.
Exercise and Diastolic Dysfunction
During exercise, the heart is normally able to substantially increase the amount of blood it pumps with each beat.Part of this increase, of course, is a stronger contraction during systole, in order to eject blood faster. But equally important is an ability to rapidly fill the heart with blood during diastole. Diastolic dysfunction—a stiff heart muscle—prevents this rapid filling. As a result, the amount of blood the heart can pump with each heartbeat is limited.
Patients with diastolic dysfunction typically have a limited exercise capacity, and they often complain ofdyspneaon relatively minimal exertion.
How Aerobic Exercise Training Helps
It has been known for a long time that regular aerobic training can substantially improve exercise capacity and quality of life in patients with typical heart failure—that is, heart failure associated with a weakened, dilated heart muscle (also known asdilated cardiomyopathy).
More recently, it has been demonstrated that the same kinds of results can be achieved with aerobic training in patients with diastolic dysfunction. In particular, regular aerobic exercise can actually reduce the stiffening of the heart muscle and improve the filling of the heart during diastole.
Randomized trialsin patients with diastolic heart failure have demonstrated that regular aerobic training for three to four months can significantly improve exercise capacity, symptoms of shortness of breath with exertion, and quality of life measures.
It is important to stress that with diastolic dysfunction it is aerobic exercise and not weight lifting or strength training that improves cardiac stiffness.
If You Have Diastolic Dysfunction
If you have diastolic dysfunction, odds are high that you will benefit from a program of aerobic exercise.Not only are you likely to feel better after a few months, but also you may begin to reverse the stiffness of your heart muscle, and (more importantly) prevent the onset of diastolic heart failure. You should talk to your healthcare provider about beginning the aerobic exercise, or even about participating in a formal cardiac rehabilitation program, to get you started in the right direction.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Leite-Moreira AF.Current perspectives in diastolic dysfunction and diastolic heart failure.Heart. 2006;92(5):712–718. doi:10.1136/hrt.2005.062950Amundsen BH, Rognmo Ø, Hatlen-Rebhan G, Slørdahl SA.High-intensity aerobic exercise improves diastolic function in coronary artery disease.Scand Cardiovasc J. 2008;42(2):110–117. doi:10.1080/14017430701744477Oberman R, Bhardwaj A.Physiology, Cardiac. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526089/van der Velden J.Diastolic myofilament dysfunction in the failing human heart.Pflugers Arch. 2011;462(1):155–163. doi:10.1007/s00424-011-0960-3Ichinose M, Ichinose-Kuwahara T, Kondo N, Nishiyasu T.Increasing blood flow to exercising muscle attenuates systemic cardiovascular responses during dynamic exercise in humans.Am J Physiol Regul Integr Comp Physiol. 2015;309(10):R1234–R1242. doi:10.1152/ajpregu.00063.2015Nasim S, Nadeem N, Zahidie A, Sharif T.Relationship between exercise induced dyspnea and functional capacity with doppler-derived diastolic function'.BMC Res Notes. 2013;6:150. doi:10.1186/1756-0500-6-150Mahmaljy H, Singhal M.Dilated cardiomyopathy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441911/Nystoriak MA, Bhatnagar A.Cardiovascular effects and benefits of exercise.Front Cardiovasc Med. 2018;5:135. doi:10.3389/fcvm.2018.00135Agarwal SK.Cardiovascular benefits of exercise.Int J Gen Med. 2012;5:541–545. doi:10.2147/IJGM.S30113Patel H, Alkhawam H, Madanieh R, Shah N, Kosmas CE, Vittorio TJ.Aerobicvsanaerobic exercise training effects on the cardiovascular system.World J Cardiol. 2017;9(2):134–138. doi:10.4330/wjc.v9.i2.134Trankle C, Canada JM, Buckley L, et al.Impaired myocardial relaxation with exercise determines peak aerobic exercise capacity in heart failure with preserved ejection fraction.ESC Heart Fail. 2017;4(3):351–355. doi:10.1002/ehf2.12147Additional ReadingEdelmann F, Gelbrich G, Düngen HD, et al.Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study.J Am Coll Cardiol. 2011;58:1780. doi:10.1016/j.jacc.2011.06.054Kitzman DW, Brubaker PH, Morgan TM, et al.Exercise training in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial.Circ Heart Fail. 2010;3:659. doi:10.1056/NEJMoa032566Zile MR, Baicu CF, Gaasch WH.Diastolic heart failure—abnormalities in active relaxation and passive stiffness of the left ventricle.N Engl J Med. 2004;350:1953. doi:10.1056/NEJMoa032566
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Leite-Moreira AF.Current perspectives in diastolic dysfunction and diastolic heart failure.Heart. 2006;92(5):712–718. doi:10.1136/hrt.2005.062950Amundsen BH, Rognmo Ø, Hatlen-Rebhan G, Slørdahl SA.High-intensity aerobic exercise improves diastolic function in coronary artery disease.Scand Cardiovasc J. 2008;42(2):110–117. doi:10.1080/14017430701744477Oberman R, Bhardwaj A.Physiology, Cardiac. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526089/van der Velden J.Diastolic myofilament dysfunction in the failing human heart.Pflugers Arch. 2011;462(1):155–163. doi:10.1007/s00424-011-0960-3Ichinose M, Ichinose-Kuwahara T, Kondo N, Nishiyasu T.Increasing blood flow to exercising muscle attenuates systemic cardiovascular responses during dynamic exercise in humans.Am J Physiol Regul Integr Comp Physiol. 2015;309(10):R1234–R1242. doi:10.1152/ajpregu.00063.2015Nasim S, Nadeem N, Zahidie A, Sharif T.Relationship between exercise induced dyspnea and functional capacity with doppler-derived diastolic function'.BMC Res Notes. 2013;6:150. doi:10.1186/1756-0500-6-150Mahmaljy H, Singhal M.Dilated cardiomyopathy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441911/Nystoriak MA, Bhatnagar A.Cardiovascular effects and benefits of exercise.Front Cardiovasc Med. 2018;5:135. doi:10.3389/fcvm.2018.00135Agarwal SK.Cardiovascular benefits of exercise.Int J Gen Med. 2012;5:541–545. doi:10.2147/IJGM.S30113Patel H, Alkhawam H, Madanieh R, Shah N, Kosmas CE, Vittorio TJ.Aerobicvsanaerobic exercise training effects on the cardiovascular system.World J Cardiol. 2017;9(2):134–138. doi:10.4330/wjc.v9.i2.134Trankle C, Canada JM, Buckley L, et al.Impaired myocardial relaxation with exercise determines peak aerobic exercise capacity in heart failure with preserved ejection fraction.ESC Heart Fail. 2017;4(3):351–355. doi:10.1002/ehf2.12147Additional ReadingEdelmann F, Gelbrich G, Düngen HD, et al.Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study.J Am Coll Cardiol. 2011;58:1780. doi:10.1016/j.jacc.2011.06.054Kitzman DW, Brubaker PH, Morgan TM, et al.Exercise training in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial.Circ Heart Fail. 2010;3:659. doi:10.1056/NEJMoa032566Zile MR, Baicu CF, Gaasch WH.Diastolic heart failure—abnormalities in active relaxation and passive stiffness of the left ventricle.N Engl J Med. 2004;350:1953. doi:10.1056/NEJMoa032566
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Leite-Moreira AF.Current perspectives in diastolic dysfunction and diastolic heart failure.Heart. 2006;92(5):712–718. doi:10.1136/hrt.2005.062950Amundsen BH, Rognmo Ø, Hatlen-Rebhan G, Slørdahl SA.High-intensity aerobic exercise improves diastolic function in coronary artery disease.Scand Cardiovasc J. 2008;42(2):110–117. doi:10.1080/14017430701744477Oberman R, Bhardwaj A.Physiology, Cardiac. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526089/van der Velden J.Diastolic myofilament dysfunction in the failing human heart.Pflugers Arch. 2011;462(1):155–163. doi:10.1007/s00424-011-0960-3Ichinose M, Ichinose-Kuwahara T, Kondo N, Nishiyasu T.Increasing blood flow to exercising muscle attenuates systemic cardiovascular responses during dynamic exercise in humans.Am J Physiol Regul Integr Comp Physiol. 2015;309(10):R1234–R1242. doi:10.1152/ajpregu.00063.2015Nasim S, Nadeem N, Zahidie A, Sharif T.Relationship between exercise induced dyspnea and functional capacity with doppler-derived diastolic function'.BMC Res Notes. 2013;6:150. doi:10.1186/1756-0500-6-150Mahmaljy H, Singhal M.Dilated cardiomyopathy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441911/Nystoriak MA, Bhatnagar A.Cardiovascular effects and benefits of exercise.Front Cardiovasc Med. 2018;5:135. doi:10.3389/fcvm.2018.00135Agarwal SK.Cardiovascular benefits of exercise.Int J Gen Med. 2012;5:541–545. doi:10.2147/IJGM.S30113Patel H, Alkhawam H, Madanieh R, Shah N, Kosmas CE, Vittorio TJ.Aerobicvsanaerobic exercise training effects on the cardiovascular system.World J Cardiol. 2017;9(2):134–138. doi:10.4330/wjc.v9.i2.134Trankle C, Canada JM, Buckley L, et al.Impaired myocardial relaxation with exercise determines peak aerobic exercise capacity in heart failure with preserved ejection fraction.ESC Heart Fail. 2017;4(3):351–355. doi:10.1002/ehf2.12147
Leite-Moreira AF.Current perspectives in diastolic dysfunction and diastolic heart failure.Heart. 2006;92(5):712–718. doi:10.1136/hrt.2005.062950
Amundsen BH, Rognmo Ø, Hatlen-Rebhan G, Slørdahl SA.High-intensity aerobic exercise improves diastolic function in coronary artery disease.Scand Cardiovasc J. 2008;42(2):110–117. doi:10.1080/14017430701744477
Oberman R, Bhardwaj A.Physiology, Cardiac. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526089/
van der Velden J.Diastolic myofilament dysfunction in the failing human heart.Pflugers Arch. 2011;462(1):155–163. doi:10.1007/s00424-011-0960-3
Ichinose M, Ichinose-Kuwahara T, Kondo N, Nishiyasu T.Increasing blood flow to exercising muscle attenuates systemic cardiovascular responses during dynamic exercise in humans.Am J Physiol Regul Integr Comp Physiol. 2015;309(10):R1234–R1242. doi:10.1152/ajpregu.00063.2015
Nasim S, Nadeem N, Zahidie A, Sharif T.Relationship between exercise induced dyspnea and functional capacity with doppler-derived diastolic function'.BMC Res Notes. 2013;6:150. doi:10.1186/1756-0500-6-150
Mahmaljy H, Singhal M.Dilated cardiomyopathy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441911/
Nystoriak MA, Bhatnagar A.Cardiovascular effects and benefits of exercise.Front Cardiovasc Med. 2018;5:135. doi:10.3389/fcvm.2018.00135
Agarwal SK.Cardiovascular benefits of exercise.Int J Gen Med. 2012;5:541–545. doi:10.2147/IJGM.S30113
Patel H, Alkhawam H, Madanieh R, Shah N, Kosmas CE, Vittorio TJ.Aerobicvsanaerobic exercise training effects on the cardiovascular system.World J Cardiol. 2017;9(2):134–138. doi:10.4330/wjc.v9.i2.134
Trankle C, Canada JM, Buckley L, et al.Impaired myocardial relaxation with exercise determines peak aerobic exercise capacity in heart failure with preserved ejection fraction.ESC Heart Fail. 2017;4(3):351–355. doi:10.1002/ehf2.12147
Edelmann F, Gelbrich G, Düngen HD, et al.Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study.J Am Coll Cardiol. 2011;58:1780. doi:10.1016/j.jacc.2011.06.054Kitzman DW, Brubaker PH, Morgan TM, et al.Exercise training in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial.Circ Heart Fail. 2010;3:659. doi:10.1056/NEJMoa032566Zile MR, Baicu CF, Gaasch WH.Diastolic heart failure—abnormalities in active relaxation and passive stiffness of the left ventricle.N Engl J Med. 2004;350:1953. doi:10.1056/NEJMoa032566
Edelmann F, Gelbrich G, Düngen HD, et al.Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study.J Am Coll Cardiol. 2011;58:1780. doi:10.1016/j.jacc.2011.06.054
Kitzman DW, Brubaker PH, Morgan TM, et al.Exercise training in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial.Circ Heart Fail. 2010;3:659. doi:10.1056/NEJMoa032566
Zile MR, Baicu CF, Gaasch WH.Diastolic heart failure—abnormalities in active relaxation and passive stiffness of the left ventricle.N Engl J Med. 2004;350:1953. doi:10.1056/NEJMoa032566
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