{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:09:59Z","timestamp":1793725799374,"version":"4.6.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Spanish Ministry of Economy and Competitiveness","award":["PI22\/00535"],"award-info":[{"award-number":["PI22\/00535"]}]},{"name":"CIBER Cardiovascular","award":["16\/11\/00420"],"award-info":[{"award-number":["16\/11\/00420"]}]},{"name":"CIBER Cardiovascular","award":["16\/11\/00403"],"award-info":[{"award-number":["16\/11\/00403"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Chronotropic incompetence (ChI) in heart failure with preserved ejection fraction (HFpEF) is associated with a reduced exercise capacity. The role of exercise training in improving chronotropic response (ChR) and functional capacity in these patients remains uncertain. This study assessed the effects of four different exercise programmes on peak oxygen consumption (peakVO\u2082), Kansas City Cardiomyopathy Questionnaire (KCCQ) score, and ChR in patients with the ChI HFpEF phenotype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this randomized clinical trial, 80 symptomatic (NYHA classes II\u2013III\/IV) patients with the ChI HFpEF phenotype were randomized (1:1:1:1) to one of four interventions: (i) a 12-week supervised aerobic training (AT) programme, (ii) AT with low-intensity strength training (AT\/LRT), (iii) AT with moderate- to high-intensity strength training (AT\/HRT), or (iv) non-supervised exercise recommendations (ER). The primary endpoint was the change in peakVO2 at 12 weeks. Secondary endpoints included changes in ChR and KCCQ. A linear regression model was used. The mean age of 80 participants was 75.1 \u00b1 7.2 years, and 59.6% were women. Baseline values for peakVO2, chronotropic index, and KCCQ were 11.8 \u00b1 2.6\u2005mL\/kg\/min, 0.4 \u00b1 0.2, and 63.5 \u00b1 17.9, respectively, with no significant differences across arms. All supervised training programmes led to significant improvements in peakVO2 compared to ER: AT\/HRT: \u0394 + 4.0 [95% confidence interval (CI): 2.9\u20135.1, P &amp;lt; 0.001], AT\/LRT: \u0394 + 3.6 (95% CI: 2.5\u20134.6, P &amp;lt; 0.001), and AT: \u0394 + 2.9 (95% CI: 1.9\u20134.0, P &amp;lt; 0.001). AT\/HRT was superior over AT alone: \u0394 + 1.1 (95% CI, 0.1\u20132.2, P = 0.046). Likewise, supervised exercise improved ChR and KCCQ without statistical differences between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Different supervised exercise training improved peakVO2, ChR, and KCCQ in patients with ChI HFpEF phenotype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov (NCT05649787).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf269","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T07:37:39Z","timestamp":1745825859000},"page":"265-275","source":"Crossref","is-referenced-by-count":14,"title":["Effect of exercise training in patients with chronotropic incompetence and heart failure with preserved ejection fraction: the TRAINING-HR randomized clinical trial"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5040-0924","authenticated-orcid":false,"given":"Patricia","family":"Palau","sequence":"first","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universitat de Val\u00e8ncia , Av. de Blasco Ib\u00e1\u00f1ez, 17, 46010 Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iv\u00e1n","family":"de Amo","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universitat de Val\u00e8ncia , Av. de Blasco Ib\u00e1\u00f1ez, 17, 46010 Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universitat de Val\u00e8ncia , Av. de Blasco Ib\u00e1\u00f1ez, 17, 46010 Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Flor","sequence":"additional","affiliation":[{"name":"Physiotherapy Department, Universitat de Val\u00e8ncia , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8720-3999","authenticated-orcid":false,"given":"Rafael","family":"de la Espriella","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universitat de Val\u00e8ncia , Av. de Blasco Ib\u00e1\u00f1ez, 17, 46010 Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia","family":"Garc\u00eda-Conejo","sequence":"additional","affiliation":[{"name":"Physiotherapy Department, University of Malaga, Grupo de Investigaci\u00f3n Clinimetr\u00eda F14, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), Malaga 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Cl\u00ednico Universitario, INCLIVA, Universitat de Val\u00e8ncia , Av. de Blasco Ib\u00e1\u00f1ez, 17, 46010 Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabi\u00e1n","family":"Sanchis-Gomar","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Stanford University School of Medicine , Stanford, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4398-5642","authenticated-orcid":false,"given":"Markus","family":"Meyer","sequence":"additional","affiliation":[{"name":"Lillehei Heart Institute, Department of Medicine, University of Minnesota College of Medicine , Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0797-8709","authenticated-orcid":false,"given":"Juan","family":"Sanchis","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico 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