Pumping iron for a stronger heart: can resistance training reverse muscle loss in seniors?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Aged ≥ 60 years old * Meet the diagnostic criteria of 2019 AWGS2 sarcopenia, can be diagnosed once meeting (1) + (2) or (1) + (3) or (1) + (2) + (3): (1) Appendicular skeletal muscle mass (ASM): dual-energy X-ray absorptiometry (DXA) (male \<7.0 kg/m², female \<5.4 kg/m²). (2) Muscle strength: handgrip strength (male \<28.0 kg, female \<18.0 kg). (3) Physical performance: 6-meter walking speed \<1.0 m/s. * Meet the diagnostic criteria of heart failure following ESC 2021. * Clearly understand the content and purpose of the study and sign the informed consent form. Exclusion Criteria: There are contraindications for Exercise Testing in patients with stable heart failure according to ACSM 2022: * Early stage after acute coronary syndrome (within the first 2 days) * Unstable coronary artery disease * Decompensated heart failure * Acute venous thrombosis or recent arterial embolism (pulmonary or systemic) * Acute myocarditis, pericarditis, endocarditis * Aortic dissection of the valve * Severe symptomatic aortic stenosis * Acute systemic disease or fever * Uncontrolled or life-threatening atrial or ventricular arrhythmias (including new-onset atrial fibrillation or flutter) * Uncontrolled tachycardia (resting heart rate \> 120 beats per minute) * Third-degree AV block * Uncontrolled diabetes * Symptomatic orthostatic hypotension (\> 20 mmHg) * Gradually increasing fatigue during exercise or dyspnea at rest or with exertion within the past 3-5 days * Significant myocardial ischemia at low workloads \< 2 METs or 50W * Relative contraindications according to ACSM 2022: * Weight gain ≥ 1.8 kg in the past 1-3 days * Simultaneous use of continuous or intermittent Dobutamine * Decrease in blood pressure with exercise * NYHA IV heart failure * Complex ventricular arrhythmias at rest or with exertion * Resting heart rate ≥ 100 bpm when lying down * Comorbidities that limit exercise * Severe obstructive hypertrophic cardiomyopathy * Have participated in a cardiovascular rehabilitation program within the last 6 months * Do not agree to participate in the study