Exercise training is a fundamental part of heart failure with reduced ejection fraction (HF-REF) treatment. It reduces mortality and hospitalizations and improves functional capacities. The aim of this study was to find predictive factors of improvement of physical ability in HF-REF patients after completion of an exercise training program.

Functional, clinical, biological and echocardiographic data, were retrospectively analysed in 50 HF-REF patients who underwent an exercise training program in our center in 2013. The improvement of physical abilities was defined by an increase of 1 or more metabolic equivalent (MET) between the first and the final exercise testing.

Patients were 58.3±12.1 years old with a mean ejection fraction of 34±10% and an average of 18.7 sessions over a 4 month period was performed. Mean pre and post training MET were respectively 4.9±1.6 and 6.1±2.3 (p<0.001). At the end of the training period, 22 patients displayed an improved exercise testing. Exercise testing improvement was associated with the absence of arterial hypertension (57% versus 27% p=0.04), and a tendency was seen with lower furosemide daily intake (25.7mg versus 84.3mg p=0.05), and lower Heart Failure Risk of Death at 1 year calculation (7.02% versus 10.22% p=0.05). Pre-training exercise capacity was not associated with post-training improvement (4.6±1.5 MET versus 5.2±1.8 MET p=0.17).

HF-REF patients without previous arterial hypertension had more chance to improve physical capacities after exercise training program.