Exercise Mode in Heart Failure: A Systematic Review and Meta-Analysis.
Journal article
Edwards, J., Shanmugam, Nesan, Ray, Robin, Jouhra, Fadi, Mancio, Jennifer, Wiles, Jonathan, Marciniak, Anna, Sharma, Rajan and O'Driscoll, J. 2023. Exercise Mode in Heart Failure: A Systematic Review and Meta-Analysis. Sports Medicine - Open. 9 (1), p. 3. https://doi.org/10.1186/s40798-022-00549-1
Authors | Edwards, J., Shanmugam, Nesan, Ray, Robin, Jouhra, Fadi, Mancio, Jennifer, Wiles, Jonathan, Marciniak, Anna, Sharma, Rajan and O'Driscoll, J. |
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Abstract | <h4>Background</h4>Optimising 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 (VO<sub>2</sub>), as well as other clinically relevant parameters.<h4>Methods</h4>A 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 VO<sub>2</sub> in HFpEF or HFrEF were considered. Left-ventricular ejection fraction (LVEF) and various markers of diastolic function were also analysed.<h4>Results</h4>Seventeen 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 VO<sub>2</sub> (weighted mean difference [WMD]: 0.521 ml min<sup>-1</sup> kg<sup>-1</sup>, [95% CI] = - 0.7 to 1.8, P<sub>fixed</sub> = 0.412) or LVEF (WMD: - 1.129%, [95% CI] = - 3.8 to 1.5, P<sub>fixed</sub> = 0.408). However, HIIT was significantly more effective than MIT at improving peak VO<sub>2</sub> (WMD: 1.62 ml min<sup>-1</sup> kg<sup>-1</sup>, [95% CI] = 0.6-2.6, P<sub>random</sub> = 0.002) and LVEF (WMD: 3.24%, [95% CI] = 1.7-4.8, P<sub>random</sub> < 0.001) in HF patients. When dichotomized by HF phenotype, HIIT remained significantly more effective than MIT in all analyses except for peak VO<sub>2</sub> in HFpEF.<h4>Conclusions</h4>HIIT is significantly more effective than MIT for improving peak VO<sub>2</sub> and LVEF in HF patients. With the exception of peak VO<sub>2</sub> in HFpEF, these findings remain consistent in both phenotypes. Separately, there is no difference in peak VO<sub>2</sub> and LVEF change following MIT or CT, suggesting that the addition of resistance exercise does not inhibit aerobic adaptations in HF. |
Keywords | Heart Failure; Exercise Training; Hfpef; Hfref; Exercise Mode |
Year | 2023 |
Journal | Sports Medicine - Open |
Journal citation | 9 (1), p. 3 |
Publisher | Springer |
ISSN | 2199-1170 |
2198-9761 | |
Digital Object Identifier (DOI) | https://doi.org/10.1186/s40798-022-00549-1 |
Official URL | https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-022-00549-1 |
Publication dates | |
Online | 09 Jan 2023 |
01 Jan 2023 | |
Publication process dates | |
Deposited | 12 Jan 2023 |
Accepted | 20 Dec 2022 |
Publisher's version | File Access Level Open |
Output status | Published |
Additional information | Publications router: Date 2023-01-09 of type 'publication_date' with format 'electronic' included in notification |
Publications router: License for this article: cc by included in notification | |
License | CC BY |
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https://repository.canterbury.ac.uk/item/93886/exercise-mode-in-heart-failure-a-systematic-review-and-meta-analysis
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