Clinical outcomes and cardiovascular responses to exercise training in heart failure patients with preserved ejection fraction: a systematic review and meta-analysis

Title
Clinical outcomes and cardiovascular responses to exercise training in heart failure patients with preserved ejection fraction: a systematic review and meta-analysis
Publication Date
2015
Author(s)
Dieberg, Gudrun
( author )
OrcID: https://orcid.org/0000-0001-7191-182X
Email: gdieberg@une.edu.au
UNE Id une-id:gdieberg
Ismail, Hashbullah
Giallauria, Francesco
Smart, Neil
( author )
OrcID: https://orcid.org/0000-0002-8290-6409
Email: nsmart2@une.edu.au
UNE Id une-id:nsmart2
Type of document
Journal Article
Language
en
Entity Type
Publication
Publisher
American Physiological Society
Place of publication
United States of America
DOI
10.1152/japplphysiol.00904.2014
UNE publication id
une:18147
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 ml.kg⁻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 ml.kg⁻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.
Link
Citation
Journal of Applied Physiology, 119(6), p. 726-733
ISSN
1522-1601
8750-7587
Start page
726
End page
733

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