Open AccessEffects of exercise training on left ventricular remodelling in heart failure patients: an updated meta‐analysis of randomised controlled trials
Author(s) -
Chen Y. M.,
Li Z. B.,
Zhu M.,
Cao Y. M.
Publication year - 2012
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/j.1742-1241.2012.02942.x
Subject(s) - medicine , meta analysis , confidence interval , ejection fraction , aerobic exercise , subgroup analysis , heart failure , strictly standardized mean difference , randomized controlled trial , cardiology , physical therapy
Summary Objectives: The purpose of this updated meta‐analysis was to determine whether exercise training reversed left ventricular remodelling in heart failure patients. Methods: Articles were searched in MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, EMBASE and PubMed (up until October, 2011). The anti‐remodelling benefit of exercise training was assessed by ejection fraction (EF), end‐diastolic volume (EDV) and end‐systolic volume (ESV). Standardised mean difference (SMD) together with 95% confidence intervals (CI) was calculated. Subgroup meta‐analysis with exercise duration was also conducted. Results: Fifteen randomised controlled trials with 813 patients were included. Aerobic exercise training improved EF (SMD = 0.44; 95% CI 0.28 to 0.61), EDV (SMD = −0.33; 95% CI −0.49 to −0.16) and ESV (SMD = −0.40; 95% CI −0.57 to −0.23). Subgroup analysis indicated that long‐term aerobic exercise (≥6 months) had a marked positive effect on EF (SMD = 0.5; 95% confidence interval 0.31 to 0.69), EDV (SMD = −0.38; 95% CI −0.57 to −0.19) and ESV (SMD = −0.48; 95% CI −0.67 to −0.29), but there was no evidence of benefit with short‐term aerobic exercise (<6 months): EF (SMD = 0.27; 95% CI −0.08 to 0.61), EDV (SMD = −0.14; 95% CI −0.48 to 0.21) and ESV (SMD = −0.08; 95% CI −0.47 to 0.30). Strength training (alone or plus aerobic training) was not associated with improvements in EDV and ESV, with all confidence intervals including 0. Conclusions: Aerobic exercise training, especially long‐term duration (≥6 months) reverses left ventricular remodelling in clinically stable patients with heart failure. Strength training (alone or plus aerobic training) did not improve or worsen ventricular remodelling.