**8.1 Exercise testing**

Symptom-limited exercise testing is safe in patients with HFrEF and when combined with the indirect measurement of expired gases provides not only useful information pertaining to electrocardiographic and hemodynamic responses to exercise but prognostic information as well [39]. Age-matched healthy individuals, patients with HFrEF exhibit a lesser peak HR, peak stroke volume, and peak cardiac output response to exercise. Vasodilation of the larger vessels and resistance vasculature are weakened, reducing regional and local blood flow. Exercise tolerance


**Table 6.**

*FITT principle for patients with heart failure.*

*Exercise Prescriptions for Co-Morbid Conditions DOI: http://dx.doi.org/10.5772/intechopen.98339*

falls to 30–40% as compared to controls. An exercise regimen that starts at a lower work rate and uses stepwise increase in work rate per stage is commonly used. Both O2 peak and the slope relationship between minute ventilation and carbon dioxide production (E– CO2 slope) are related to prognosis and can serve as a guide as to when to consult Cardiologist [39].

## **8.2 Exercise prescription**

The two main goals for exercise training in patients with HF are to reverse exercise intolerance and decrease subsequent risk for a clinical event, the principle of specificity of training dictates the use of exercise modalities that were used in trials that reported improved functional and clinical benefits (**Table 6**). Therefore, exercise regimens should always include aerobic activities.
