Non-Invasive Ventilatory Support as a Tool to Improve Exercise Tolerance in Patients With Heart Failure: A Systematic Review With Meta-Analysis.

IF 1.8 Q3 REHABILITATION

Physiotherapy Research International Pub Date : 2025-04-01 DOI:10.1002/pri.70037

Jessiane Bianca Pinheiro da Silva, Maria Carolina Rosário Santana, Bruno Prata Martinez, Helder Brito Duarte

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引用次数: 0

Abstract

Background and purpose: Heart failure (HF) is a complex syndrome that impacts persons' daily activities and adherence to exercise programs. Non-Invasive ventilation (NIV) reduces respiratory load and improves cardiac function, potentially serving as an important adjunct in its treatment. These effects can be enhanced with a cardiac rehabilitation program, improving dyspnea and functionality. This study aimed to evaluate the effects of NIV during exercise on functional performance outcomes, dyspnea, QL, hemodynamics, and respiratory function.

Methods: A systematic review followed by meta-analysis was conducted. Searches were performed in PubMed, CENTRAL, Embase, LILACS, SciELO, and CINAHL.

Eligibility criteria: Randomized clinical trials of patients over 18 years of age with HF, compared to a control group, were included with the objective of improving exercise tolerance. The studies were categorized as short-term effects of NIV and those implementing an exercise program.

Results: Seven studies were included in the qualitative review and five in the meta-analysis. Only two studies presented a low risk of bias. The analyzed outcomes were the 6-min walk test (6MWT), dyspnea, SpO2, heart rate (HR), systolic, and diastolic arterial pressure (SAP and DAP, respectively), maximal inspiratory and expiratory muscle strength (MIP and MEP, respectively), forced expiratory volume in one second (FEV1), and quality of life (QL).

Discussion: There was a significant difference in favor of the NIV group compared to the control group in both modalities in relation to the 6MWT, with a mean difference (MD) 41.72 (CI 95% 2.15, 81.29) meters in the exercise program and MD 68.61 (CI 95% 5.69, 131.54) meters in short-term effect studies. There were also favorable results in the outcomes of dyspnea and FEV1 in the NIV group (p < 0.01). There were no statistically significant differences in the outcomes peripheral oxygen saturation (p = 0.11), systolic (p = 0.76) and diastolic blood pressure (p = 0.93), heart rate (p = 0.19), MIP (p = 0.49), MEP (p = 0.22) and QL (p = 0.13).

Trail registration: PROSPERO CRD42022367746.

查看原文本刊更多论文

无创通气支持作为提高心力衰竭患者运动耐受性的工具：荟萃分析的系统回顾

背景和目的：心力衰竭（HF）是一种复杂的综合征，影响人们的日常活动和坚持锻炼计划。无创通气（NIV）可减轻呼吸负荷，改善心功能，有可能成为其治疗的重要辅助手段。这些效果可以通过心脏康复计划来增强，改善呼吸困难和功能。本研究旨在评估运动期间NIV对功能表现结果、呼吸困难、QL、血流动力学和呼吸功能的影响。方法：进行系统综述和meta分析。在PubMed、CENTRAL、Embase、LILACS、SciELO和CINAHL中进行检索。资格标准：18岁以上HF患者的随机临床试验，与对照组进行比较，目的是提高运动耐受性。这些研究被归类为NIV的短期效果和那些实施锻炼计划的研究。结果：定性评价纳入7项研究，meta分析纳入5项研究。只有两项研究显示低偏倚风险。分析结果为6分钟步行试验（6MWT）、呼吸困难、SpO2、心率（HR）、收缩压和舒张压（SAP和DAP）、最大吸气和呼气肌力量（MIP和MEP）、1秒用力呼气量（FEV1）和生活质量（QL）。讨论：与对照组相比，在两种模式下，与6MWT相关的NIV组有显著差异，运动计划的平均差异（MD）为41.72 （CI 95% 2.15, 81.29）米，短期效果研究的MD为68.61 （CI 95% 5.69, 131.54）米。NIV组在呼吸困难和FEV1方面也有良好的结果（p Trail注册：PROSPERO CRD42022367746）。

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来源期刊

Physiotherapy Research International REHABILITATION-

CiteScore

3.30

自引率

5.90%

发文量

期刊介绍： Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.