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Title: Clinical outcomes and cardiovascular responses to exercise training in heart failure patients with preserved ejection fraction: a systematic review and meta-analysis
Contributor(s): Dieberg, Gudrun  (author)orcid ; Ismail, Hashbullah  (author); Giallauria, Francesco  (author); Smart, Neil  (author)orcid 
Publication Date: 2015
Open Access: Yes
DOI: 10.1152/japplphysiol.00904.2014Open Access Link
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Abstract: Exercise training induces physical adaptations for heart failure patients with systolic dysfunction, but less is known about those patients with preserved ejection fraction. To establish whether exercise training produces changes in peak VO₂ and related measures, quality of life, general health, and diastolic function in heart failure patients with preserved ejection fraction. We conducted a MEDLINE search (1985 to October 10, 2014), for exercise-based rehabilitation trials in heart failure, using search terms "exercise training, heart failure with preserved ejection fraction, heart failure with normal ejection fraction, peak VO₂, and diastolic heart dysfunction". Seven intervention studies were included providing a total of 144 exercising subjects and 114 control subjects, a total of 258 participants. Peak VO₂ increased by a mean difference (MD) 2.13⁻¹.min⁻¹ [95% confidence interval (CI) 1.54 to 2.71, P < 0.00001] in exercise training vs. sedentary control, equating to a 17% improvement from baseline. The corresponding data are provided for the following exercise test variables: VE/VCO₂ slope, MD 0.85⁻¹.min⁻¹ (95% CI 0.05 to 1.65, P = 0.04); maximum heart rate, MD 5.60 beats per minute (95% CI 3.95 to 7.25, P < 0.00001); Six-Minute Walk Test, MD 32.1 m (95% CI 17.2 to 47.1, P < 0.0001); and indices of diastolic function: E/A ratio, MD 0.07 (95% CI 0.02 to 0.12, P = 0.005); E/E' ratio MD -2.31 (95% CI -3.44 to -1.19, P < 0.0001); deceleration time (DT), MD -13.2 ms (95% CI -19.8 to -6.5, P = 0.0001); and quality of life: Minnesota Living with Heart Failure Questionnaire, MD -6.50 (95% CI -9.47 to -3.53, P < 0.0001); and short form-36 health survey (physical dimension), MD 15.6 (95% CI 7.4 to 23.8, P = 0.0002). In 3,744 h patient-hours of training, not one death was directly attributable to exercise. Exercise training appears to effect several health-related improvements in people with heart failure and preserved ejection fraction.
Publication Type: Journal Article
Source of Publication: Journal of Applied Physiology, 119(6), p. 726-733
Publisher: American Physiological Society
Place of Publication: United States of America
ISSN: 8750-7587
Field of Research (FOR): 110201 Cardiology (incl Cardiovascular Diseases)
110602 Exercise Physiology
Socio-Economic Outcome Codes: 920201 Allied Health Therapies (excl. Mental Health Services)
920103 Cardiovascular System and Diseases
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
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