Aerobic, resistance, and specialized exercise training in heart failure with preserved ejection fraction: A state-of-the-art review.

Heart failure with preserved ejection fraction (HFpEF) is a growing public health burden, contributing to significant morbidity, mortality, and healthcare costs. Exercise intolerance, a hallmark of HFpEF, stems from central (cardiac and pulmonary) and peripheral (vascular and skeletal muscle) factors that result in reduced oxygen delivery and utilization by active muscles. With relatively few effective therapies, exercise training has emerged as a reliable and proven therapeutic intervention to improve exercise capacity and physical function in HFpEF.