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June 12, 2026European Journal of Preventive CardiologyOpen Access

High compliant patients improved HR at ventilatory anaerobic threshold whereas low compliant patients showed a reduction (3.7±9.9 vs -5.35±16.7 bpm, p = 0.0005).

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Why the study?

Does higher compliance to a personalized physical activity program improve physical fitness in patients with HFpEF?

Population

107 patients with heart failure with preserved ejection fraction from the intervention arm of the PRIORITY…

Comparison

High compliance to a hybrid exercise and… vs Low compliance to the same hybrid exercise and…

Design

Cohort

Follow-up

4 months

Authors

DFD FilosJCJ ClaesYBY Bekhuis

Discussion

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Overview

Target adherence to maximize hybrid exercise benefits in HFpEF; extends RCT evidence linking compliance to fitness gains.

Key Points

  • This analysis examines how compliance with a hybrid exercise program influences physical fitness in HFpEF patients.
  • 156 HFpEF patients randomized to a hybrid intervention with 10 supervised and home-based sessions.
  • Compliance assessed using weekly TRIMP and spectral clustering to identify high and low compliance groups.
  • Physical fitness measured at baseline and after 4 months using cardiopulmonary exercise test.
  • Identified 49 highly compliant and 58 low compliant patients, with significant differences in HR@VAT (p < 0.0001).
  • Highly compliant patients improved HR@VAT (3.7±9.9 bpm) while low compliant patients decreased (-5.35±16.7 bpm, p = 0.0005).
  • Mixed-effects models confirmed significant interactions for VO2VAT, workload, and HR@VAT across compliance clusters over time.

Structured PICO

Does higher compliance to a personalized physical activity program improve physical fitness in patients with HFpEF?

P
Population
107 patients with heart failure with preserved ejection fraction (HFpEF) from the intervention arm of the PRIORITY trial
I
Intervention
High compliance (mean TRIMP 403) to a hybrid exercise and physical activity intervention combining 10 supervised sessions with a home-based remotely monitored physical activity programme over 4 months
C
Comparator
Low compliance (mean TRIMP 73) to the same hybrid exercise and physical activity intervention
O
Outcome
Changes in physical fitness parameters (HR@VAT, VO2VAT, workload at VAT) at 4 months measured by cardiopulmonary exercise testsurrogate

Higher compliance to a hybrid supervised and home-based exercise program in HFpEF patients is associated with greater short-term improvements in submaximal physical fitness parameters.

Limitations

  • Short follow-up duration

Cite This Study

Filos et al. (2026) studied this question.

synapsesocial.com/papers/6a2bd11d6550ea4541ffe926https://doi.org/10.1093/eurjpc/zwag249.046
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Patient-centered wearable-integrated rehabilitation program for patients with heart failure: a multicenter randomized controlled trial2026
  2. 2Impact of different exercise training modalities on patient-reported outcomes in heart failure with reduced and preserved ejection fraction2026
  3. 3Supervised Exercise Training for Chronic Heart Failure With Preserved Ejection Fraction: A Scientific Statement From the American Heart Association and American College of Cardiology2023 · 40 citations
  4. 4Long-Term Effects of High-Intensity Interval Training (HIIT) on Cardiac Function and Mortality in Heart Failure2025
  5. 5Physical activity and sedentary behaviour in a phase III cardiac rehabilitation program: identifying vulnerable subgroups2026