Table 1 BESMILE-HF study inclusion and exclusion criteria

Inclusion criteria

 1. Aged 18 years or above

 2. Diagnosed with chronic heart failure

 3. Clinically stable, defined as symptoms/signs that have remained generally unchanged for ≥ 1 month

 4. New York Heart Association functional classification of II or III

 5. Informed consent provided

Exclusion criteria

 1. Patients who have contraindications to exercise testing: early phase after acute coronary syndrome (up to 6 weeks); life-threatening cardiac arrhythmias; acute heart failure (during the initial period of hemodynamic instability); uncontrolled hypertension (systolic blood pressure > 200 mmHg and/or diastolic blood pressure > 110 mmHg); advanced atrioventricular block; acute myocarditis and pericarditis; moderate to severe aortic/mitral stenosis; severe aortic/mitral regurgitation; severe hypertrophic obstructive cardiomyopathy; acute systemic illness; or intracardiac thrombus.

 2. Patients who have contraindications to exercise training: progressive worsening of exercise tolerance or dyspnea at rest over the previous week; significant ischemia during low-intensity exercise (< 2 metabolic equivalents, < 50 W); uncontrolled diabetes; recent embolism; thrombophlebitis; or new-onset atrial fibrillation/atrial flutter

 3. Patients who have serious acute or chronic disease affecting major organs, or mental disorders

 4. History of cardiac surgery, cardiac resynchronization therapy, intracardiac defibrillation, or implantation of combined device within the previous 3 months

 5. History of cardiac arrest within 1 year

 6. History of peripartum cardiomyopathy, hyperthyroid heart disease, primary pulmonary hypertension

 7. Inability to perform a bicycle stress test

 8. Severe cognitive dysfunction precluding understanding of exercise concepts

 9. Current participation in either Baduanjin or a conventional cardiac rehabilitation program

 10. Participation in a concurrent trial