Exercise Mode in Heart Failure: A Systematic Review and Meta-Analysis

Sports Medicine - Open

Systematic Review

Robin Ray¹  Jennifer Mancio¹  Anna Marciniak¹  Fadi Jouhra¹  Rajan Sharma¹  Nesan Shanmugam¹  Jamie Edwards²  Jonathan Wiles²  Jamie O’Driscoll³ 

[1] Department of Cardiology, St George’s Healthcare NHS Trust, Blackshaw Road, Tooting, SW17 0QT, London, UK;School of Psychology and Life Sciences, Canterbury Christ Church University, North Holmes Road, CT1 1 QU, Canterbury, Kent, UK;School of Psychology and Life Sciences, Canterbury Christ Church University, North Holmes Road, CT1 1 QU, Canterbury, Kent, UK;Department of Cardiology, St George’s Healthcare NHS Trust, Blackshaw Road, Tooting, SW17 0QT, London, UK;

关键词: Heart failure;    HFpEF;    HFrEF;    Exercise training;    Exercise mode;   

DOI  :  10.1186/s40798-022-00549-1

 received in 2022-01-26, accepted in 2022-12-20,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundOptimising exercise prescription in heart failure (HF) with a preserved (HFpEF) or reduced (HFrEF) ejection fraction is clinically important. As such, the aim of this meta-analysis was to compare traditional moderate intensity training (MIT) against combined aerobic and resistance training (CT) and high-intensity interval training (HIIT) for improving aerobic capacity (VO2), as well as other clinically relevant parameters.MethodsA comprehensive systematic search was performed to identify randomised controlled trials published between 1990 and May 2021. Research trials reporting the effects of MIT against CT or HIIT on peak VO2 in HFpEF or HFrEF were considered. Left-ventricular ejection fraction (LVEF) and various markers of diastolic function were also analysed.ResultsSeventeen studies were included in the final analysis, 4 of which compared MIT against CT and 13 compared MIT against HIIT. There were no significant differences between MIT and CT for peak VO2 (weighted mean difference [WMD]: 0.521 ml min−1 kg−1, [95% CI] =  − 0.7 to 1.8, Pfixed = 0.412) or LVEF (WMD: − 1.129%, [95% CI] =  − 3.8 to 1.5, Pfixed = 0.408). However, HIIT was significantly more effective than MIT at improving peak VO2 (WMD: 1.62 ml min−1 kg−1, [95% CI] = 0.6–2.6, Prandom = 0.002) and LVEF (WMD: 3.24%, [95% CI] = 1.7–4.8, Prandom < 0.001) in HF patients. When dichotomized by HF phenotype, HIIT remained significantly more effective than MIT in all analyses except for peak VO2 in HFpEF.ConclusionsHIIT is significantly more effective than MIT for improving peak VO2 and LVEF in HF patients. With the exception of peak VO2 in HFpEF, these findings remain consistent in both phenotypes. Separately, there is no difference in peak VO2 and LVEF change following MIT or CT, suggesting that the addition of resistance exercise does not inhibit aerobic adaptations in HF.Graphical Abstract

【 授权许可】

CC BY   
© The Author(s) 2023

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