Eric S Leifer, Kathryn E Flynn, Steven J Keteyian, Dalane W Kitzman, Vandana Sachdev
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引用次数: 0
Abstract
Purpose: Patients with heart failure with preserved ejection fraction (HFpEF) have significant impairments in patient-reported outcomes (PRO) including physical functioning and quality of life (QOL). We conducted a meta-analysis of randomized clinical trials of supervised exercise training (SET) to examine the efficacy of such training.
Methods: We included six single-blinded SET trials in patients with HFpEF, defined as a left ventricular EF ≥50%, published since 2010 in which participants were randomized to a facility-based exercise training program or usual care. We identified trials from a 2024 Cochrane review of exercise-based cardiac rehabilitation for adults with heart failure as well as other reviews and meta-analyses in PubMed. We used random effects meta-analysis to estimate the respective SET effects for five endpoints: the 36-Item Short Form Survey (SF-36) Physical Functioning Scale (PFS), the SF-36 Physical Component Summary, the Minnesota Living With Heart Failure Questionnaire (MLWHFQ) total score, the Kansas City Cardiomyopathy Questionnaire (KCCQ) Overall Summary Score, and the KCCQ QOL subscale.
Results: The treatment effect estimate favored SET for all five endpoints. However, the SET effect was only statistically significant for the SF-36 PFS (P < .0001) and the MLWHFQ total score (P = .01).
Conclusions: This meta-analysis demonstrated clear evidence that patient-reported physical functioning, an outcome that patients with HFpEF identify as a prominent disability, is significantly improved with SET. It also showed consistent improvements across several other multi-dimensional measures of QOL.
期刊介绍：
JCRP was the first, and remains the only, professional journal dedicated to improving multidisciplinary clinical practice and expanding research evidence specific to both cardiovascular and pulmonary rehabilitation. This includes exercise testing and prescription, behavioral medicine, and cardiopulmonary risk factor management. In 2007, JCRP expanded its scope to include primary prevention of cardiovascular and pulmonary diseases. JCRP publishes scientific and clinical peer-reviewed Original Investigations, Reviews, and Brief or Case Reports focused on the causes, prevention, and treatment of individuals with cardiovascular or pulmonary diseases in both a print and online-only format. Editorial features include Editorials, Invited Commentaries, Literature Updates, and Clinically-relevant Topical Updates. JCRP is the official Journal of the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation.
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