{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:31:44Z","timestamp":1791419504928,"version":"4.3.3"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["EU-602405-2"],"award-info":[{"award-number":["EU-602405-2"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018930","name":"TUM International Graduate School of Science and Engineering","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018930","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Flemish Research Funds"},{"name":"EMVC"}],"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 (CI) is common in heart failure with preserved ejection fraction (HFpEF) and contributes to reduced exercise tolerance. However, the effects of exercise training on CI in HFpEF remain unknown. We aimed to assess the effect of different exercise training intensities on chronotropic reserve in HFpEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This is a subanalysis of the OptimEx-Clin trial. Patients with HFpEF were randomized to high-intensity interval training (HIIT), moderate continuous training (MCT) or guideline control (GC). Chronotropic incompetence was assessed during cardiopulmonary exercise testing at baseline and 3 months. Chronotropic incompetence was defined as a chronotropic index \u2264 0.62 in patients on negative chronotropic medications and \u22640.80 in others. Among 175 patients with HFpEF (66% female, mean age 70 \u00b1 8 years), 144 completed follow-up. Chronotropic incompetence was present in 51% and was associated with lower peak oxygen uptake (16.5 \u00b1 4.2 vs. 21.1 \u00b1 5.2\u2005mL\/kg\/min, P &amp;lt; 0.001), lower peak workload (89 \u00b1 28 vs. 116 \u00b1 39 W, P &amp;lt; 0.001), and poorer ventilatory efficiency (35.2 \u00b1 7.1 vs. 32.6 \u00b1 6.8, P = 0.014) at baseline. High-intensity interval training and MCT did not improve chronotropic index, %predicted peak heart rate, nor CI prevalence after 3 months (all P &amp;gt; 0.500), and adjusting for negative chronotropic drug use did not change results. Nevertheless, HIIT and MCT improved V\u0307O2peak and workload (P &amp;lt; 0.001) vs. GC, regardless of the presence of CI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In elderly patients with HFpEF, neither HIIT nor MCT during 3 months significantly improved chronotropic reserve or reduced CI prevalence, but exercise capacity was improved.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf628","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T11:32:21Z","timestamp":1759145541000},"page":"240-250","source":"Crossref","is-referenced-by-count":7,"title":["Effect of structured exercise training on chronotropic incompetence in patients with heart failure with preserved ejection fraction"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1330-2836","authenticated-orcid":false,"given":"Riwa","family":"Nasser","sequence":"first","affiliation":[{"name":"Department of Cardiology, Antwerp University Hospital (UZA) , Drie Eikenstraat 655, B2650 Edegem ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9304-0922","authenticated-orcid":false,"given":"Faro R","family":"Verelst","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Antwerp University Hospital (UZA) , Drie Eikenstraat 655, B2650 Edegem ,","place":["Belgium"]},{"name":"Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp , Campus Drie Eiken, Universiteitsplein 1, B2610 Antwerp ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1383-5715","authenticated-orcid":false,"given":"Stephan","family":"Mueller","sequence":"additional","affiliation":[{"name":"Technical University of Munich, School of Medicine and Health, Department for Preventive Sports Medicine and Sports Cardiology, TUM University Hospital , Munich ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1752-8528","authenticated-orcid":false,"given":"Ephraim B","family":"Winzer","sequence":"additional","affiliation":[{"name":"Heart Centre Dresden\u2014University Hospital, Department of Internal Medicine and Cardiology, Technische Universit\u00e4t Dresden , Dresden ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9135-110X","authenticated-orcid":false,"given":"Paul J","family":"Beckers","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp , Antwerp ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4661-4732","authenticated-orcid":false,"given":"Caroline M","family":"Van De Heyning","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Antwerp University Hospital (UZA) , Drie Eikenstraat 655, B2650 Edegem ,","place":["Belgium"]},{"name":"Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp , Campus Drie Eiken, Universiteitsplein 1, B2610 Antwerp ,","place":["Belgium"]}],"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":"Cardiac Exercise Research Group, Norwegian University of Science and Technology (NTNU) , Trondheim ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6144-4380","authenticated-orcid":false,"given":"Burkert","family":"Pieske","sequence":"additional","affiliation":[{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin , Berlin ,","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":"Heart Centre Dresden\u2014University Hospital, Department of Internal Medicine and Cardiology, Technische Universit\u00e4t Dresden , Dresden ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6222-956X","authenticated-orcid":false,"given":"Martin","family":"Halle","sequence":"additional","affiliation":[{"name":"Technical University of Munich, School of Medicine and Health, Department for Preventive Sports Medicine and Sports Cardiology, TUM University Hospital , Munich ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7686-2668","authenticated-orcid":false,"given":"Emeline M","family":"Van Craenenbroeck","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Antwerp University Hospital (UZA) , Drie Eikenstraat 655, B2650 Edegem ,","place":["Belgium"]},{"name":"Research Group Cardiovascular Diseases, 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