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Sex differences in changes of peakV\u0307O2 (absolute, relative, percent-predicted) from baseline to 3, 6, and 12 months of exercise training or usual care were compared using linear-mixed models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 498 patients (mean age 69.3 \u00b1 7.7 years, 62% women), 277 (57%) were randomized to exercise training. Exercise training significantly increased absolute, relative and percent-predicted peakV\u0307O2 compared to usual care in women (all P &amp;lt; .001), but not in men (all P &amp;gt; .05). A significant sex difference in the training response was observed for percent-predicted peakV\u0307O2 (sex * group * time-interaction P = .037). Although mean within-group changes in percent-predicted peakV\u0307O2 following exercise training were similar between women and men (4.7% [95% CI, 2.2%\u20137.2%] vs 3.0% [\u2212.3% to 6.4%] at 12 months), usual care was associated with a decline in women (\u22123.7% [\u22126.5% to \u2212.8%]) but not in men (1.4% [\u22122.0% to 4.7%]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exercise training improved percent-predicted peakV\u0307O2 in women but not in men with HFpEF, a sex difference that was largely driven by differing responses following usual care. Since women are usually underrepresented in exercise programmes, more efforts should be made to increase their participation rates (OptimEx-Clin: NCT02078947; ExDHF: ISRCTN86879094).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag240","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:14:09Z","timestamp":1785237249000},"source":"Crossref","is-referenced-by-count":2,"title":["Sex differences in exercise training response among HFpEF patients: pooled analysis of OptimEx-Clin and Ex-DHF-trials"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7409-8536","authenticated-orcid":false,"given":"Isabel","family":"Fegers-Wustrow","sequence":"first","affiliation":[{"name":"Department for Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, Technical University of Munich, TUM University Hospital , Am Olympiacampus 11, Munich 80809 ,","place":["Germany"]},{"name":"DZHK (German Centre 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,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5090-9154","authenticated-orcid":false,"given":"Volker","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology, Heart Centre Dresden, University Hospital, Technische Universit\u00e4t Dresden , Dresden ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7211-3587","authenticated-orcid":false,"given":"Ulrik","family":"Wisl\u00f8ff","sequence":"additional","affiliation":[{"name":"The Cardiac Exercise Research Group at Department of Circulation and Medical Imaging, Norwegian University of Science and Technology , Trondheim ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas B","family":"Gevaert","sequence":"additional","affiliation":[{"name":"GENCOR Department, Research Group Cardiovascular Diseases, University 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