Abstract 15264: Clinical Outcomes and Cardiovascular Responses to Exercise Training in Heart Failure Patients with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis
Background: Exercise training induces physical adaptations for heart failure patients with systolic dysfunction but less is known about those patients with preserved ejection fraction.
Objectives: To establish if 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 (HFpEF).
Methods: We conducted a MEDLINE search (1985 to March 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.
Results: Peak VO2 increased by a mean difference (MD) 2.13 ml.kg-1.min-1 (95% C.I. 1.54 to 2.71, p<0.00001) in exercise training versus sedentary control, equating to a 17% improvement from baseline. The corresponding data for VE/VCO2 slope MD 0.85 ml.kg-1.min-1 (95% C.I. 0.05 to 1.65, p=0.04); maximum heart rate MD 5.60 bpm (95% C.I. 3.95 to 7.25, p<0.00001); and 6 Minute Walk Test (6MWT) MD 32.1m (95% C.I. 17.2 to 47.1, p<0.0001); diastolic function; E/A ratio MD 0.07 (95% C.I. 0.02 to 0.12, p=0.005); E/E’ ratio MD -2.31 (95% C.I. -3.44 to -1.19, p<0.0001); Deceleration time (DT) MD -13.2 msec (95% C.I. -19.8 to -6.5, p=0.0001); Minnesota Living with Heart Failure Questionnaire (MLHFQ) MD -6.50 (95% C.I. -9.47 to -3.53, p<0.0001); Short Form (36) Health Survey MD 15.6 (95% C.I. 7.4 to 23.8, p=0.0002). In 3,744 hours patient-hours of training, not one death was directly attributable to exercise.
Conclusions: Exercise training appears to effect several health-related improvements in people with heart failure and preserved ejection fraction.
- Exercise training
- cardio-respiratory fitness
- heart failure with preserved ejection fraction
- Diastolic function
- Evidence-based medicine
- Heart failure
Author Disclosures: G. Dieberg: None. H. Ismail: None. F. Giallauria: None. N.A. Smart: None.
- © 2014 by American Heart Association, Inc.