Lack of Benefits of Endurance Training in Patients with Chronic Heart Failure: Role of Asymptomatic Peripheral Artery Disease

Exercise training has been established as an adjuvant therapy in patients with heart failure (HF) due its broad spectrum of effects including improvement of exercise tolerance, quality of life and survival [1,2]. However, some HF patients show limited improvement in exercise capacity after performing exercise training programs. This is an important point because lack of benefit to exercise training seems to be related to a poorer clinical outcome [3]. Despite some possible causes have been recently elucidated [4,5], mechanisms underlying the so called resistance to exercise training remain largely unknown.