Clinical Research Directory

Inclusion Criteria: * Patients diagnosed with heart failure with preserved ejection fraction according to 2021 ESC guidelines for Heart Failure. * Left ventricular ejection fraction (LVEF) \>40%, and/or evidence of structural and/or functional cardiac abnormality (diastolic dysfunction, elevated filling pressures, BMI\>30 kg/m2) * Elevated natriuretic peptides (BNP ≥35 pg/mL or NT-proBNP ≥125 pg/mL) * Stable symptomatic heart failure patients (New York Heart Association functional class II-III/IV) during the last month Exclusion Criteria: * Participation in cardiac rehabilitation within the past 12 months. * Contraindications to physical exercise training. * Alternative diagnoses that could explain symptoms of HF (dyspnea, fatigue), in the judgment of the cardiologist. * Significant pulmonary disease, including primary pulmonary hypertension. * Severe chronic lung disease, including COPD requiring home oxygen, chronic nebulizer therapy, long-term oral steroids, or hospitalization for decompensated pulmonary disease within the past 12 months. * Hemoglobin \<10 g/dL. * Body mass index (BMI) \>40 kg/m². * Inability to perform a valid baseline cardiopulmonary exercise test * Inability to comprehend study information or complete questionnaires (e.g., psychiatric disorder, dementia).