Effects of exercise training on cardiac performance, exercise capacity and quality of life in patients with heart failure: A meta‐analysis

Abstract

Background: Despite major advances in pharmacological treatment of chronic heart failure (CHF), a number of patients still suffer from dyspnoea, fatigue, diminished exercise capacity and poor quality of life. It is in this context that exercise training is being intensively evaluated for any additional benefit in the treatment of CHF. Aims: To determine the effect of exercise training in patients with CHF on cardiac performance, exercise capacity and health-related quality of life. A meta-analysis was performed to obtain this goal. Methods and results: After including 35 randomised controlled trials, the methodological quality of each study was assessed, summary effect sizes (SESs) and the concomitant 95% confidence intervals (95% CI) were calculated for each outcome. Quantitative analysis showed statistically significant SESs, at rest, for diastolic blood pressure and end-diastolic volume. During maximal exercise, significant SESs were found for systolic blood pressure, heart rate, cardiac output, peak oxygen uptake, anaerobic threshold and 6-min walking test. The Minnesota Living with Heart Failure Questionnaire improved by an average of 9.7 points. Conclusions: Exercise training has clinically important effects on exercise capacity and HRQL, and may have small positive effects on cardiac performance during exercise.

Correlação entre qualidade de vida e capacidade funcional na insuficiência cardíaca

“…The other studies also demonstrated associatlon of QL evaluated by MLHFQ with the variables of the cardiovasculary test, as well as the distance covered in TC6M 1,23 .…”

“…The cardiac failure (CF) is one of the main morbimortality causes all over the world, presenting increased incidence levels and prevalence with aging 1,2 . In Brazil, CF is the first cause among the hospitalization cardiovasculary diseases by Sistema Único de Saúde (SUS, Single Health System) in patients over 65 years old, increasing the costs with hospitalization and medications 3,4 .…”

Exercise training enhanced SIRT1 longevity signaling replaces the IGF1 survival pathway to attenuate aging-induced rat heart apoptosis

“…The apoptotic pathway exhibits increased levels with a reduced survival pathway in these situations. Exercise training and eating purple sweet potato yogurt can help to prevent heart failure and apoptosis Kuo et al 2005;Lin et al 2013;van Tol et al 2006;Huang et al 2012). Spontaneously hypertensive rats (SHR) of advanced age exhibit depressed myocardial contractile function and ventricular fibrosis, and as a result, stable compensatory hypertrophy progresses to heart failure.…”

Exercício intenso e suplementação de testosterona em portadores de insuficiência cardíaca

“…A superprodução e acúmulo de metabó-litos nos musculosesqueléticos, durante a atividade física, promovem a ativação do ergorreflexo, que leva a estímulos que aumentam de forma exagerada a ação dos sistemas ventilatório, hemodinâmico e sistema nervoso simpático 4 , colaborando para aparecimento da dispneia e intolerância aos esforços. O tratamento exige otimização da terapia farmacológica e não farmacológica, o que inclui programa estruturado de exercício físico 5 que, dentre outros benefícios, proporciona melhora da hiperatividade do ergorreflexo 6 , potência funcional e qualidade de vida 7 , sendo relatado que o exercício de alta intensidade promove benefícios superiores ao exercício moderado contínuo 8,9 .…”