Exercise training for systolic heart failure: Cochrane systematic review and meta‐analysis

Abstract

AimsTo determine the effect of exercise training on clinical events and health-related quality of life (HRQoL) of patients with systolic heart failure. Methods and resultsWe searched electronic databases including Medline, EMBASE, and Cochrane Library up to January 2008 to identify randomized controlled trials (RCTs) comparing exercise training and usual care with a minimum follow-up of 6 months. Nineteen RCTs were included with a total of 3647 patients, the majority of whom were male, lowto-medium risk, and New York Heart Association class II -III with a left ventricular ejection fraction of ,40%. There was no significant difference between exercise and control in short-term (≤12 months) or longer-term allcause mortality or overall hospital admissions. Heart failure-related hospitalizations were lower [relative risk: 0.72, 95% confidence interval (CI): 0.52-0.99] and HRQoL improved (standardized mean difference: 20.63, 95% CI: 20.80 to 20.37) with exercise therapy. Any effect of cardiac exercise training on total mortality and HRQoL was independent of degree of left ventricular dysfunction, type of cardiac rehabilitation, dose of exercise intervention, length of follow-up, trial quality, and trial publication date. ConclusionCompared with usual care, in selected heart failure patients, exercise training reduces heart failure-related hospitalizations and results in clinically important improvements in HRQoL. High-quality RCT and cost-effectiveness evidence is needed for the effect of exercise training in community-based settings and in more severe heart failure patients, elderly people, and women.--

Quality of life and symptoms of depression in advanced heart failure patients and their partners

“…Exercise training can reduce HF-related hospitalizations and result in clinically important improvements in quality of life (52,53). The precise mechanism through which exercise-based interventions benefit HF patients remains unclear, but both a general cardiac rehabilitation programs or more HF specific training programs might be beneficial.…”

High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in the Prevention/Management of Cardiovascular Disease

“…11 These adaptations have significant scientific and clinical relevance linked with the effective management of people at risk of developing, or afflicted with, many chronic cardiovascular disorders including coronary artery disease (CAD), [12][13][14] heart failure, [15][16][17][18] stroke, 19,20 and hypertension. 12,21 However, the specific modality of exercise and associated prescriptive variables required to accrue such clinical benefits is a contentious issue, with no clear recommendations for the prevention and/or management of cardiovascular disorders.…”

Effects of Cardiopulmonary Exercise Rehabilitation on Left Ventricular Mechanical Efficiency and Ventricular‐Arterial Coupling in Patients With Systolic Heart Failure

“…Exercise‐based cardiac rehabilitation is a recommended component of heart failure treatment1 and has a striking impact on symptoms, functional capacity, quality of life, and mortality 2, 3, 4…”