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Resistance exercise enhances oxygen uptake without worsening cardiac function in patients with systolic heart failure: a systematic review and meta-analysis

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Abstract

Recent literature suggests that resistance training (RT) improves peak oxygen uptake (\( \dot{\mathrm{V}}{\mathrm{O}}_2 \) peak), similarly to aerobic exercise (AE) in patients with heart failure (HF), but its effect on cardiac remodeling is controversial. Thus, we examined the effects of RT and AE on \( \dot{\mathrm{V}}{\mathrm{O}}_2 \) peak and cardiac remodeling in patients with heart failure (HF) via a systematic review and meta-analysis. MEDLINE, EMBASE, Cochrane Library and CINAHL, AMEDEO and PEDro databases search were extracted study characteristics, exercise type, and ventricular outcomes. The main outcomes were \( \dot{\mathrm{V}}{\mathrm{O}}_2 \) peak (ml kg−1 min−1), LVEF (%) and LVEDV (mL). Fifty-nine RCTs were included. RT produced a greater increase in \( \dot{\mathrm{V}}{\mathrm{O}}_2 \) peak (3.57 ml kg−1 min−1, P < 0.00001, I 2 = 0%) compared to AE (2.63 ml kg−1 min−1, P < 0.00001, I 2 = 58%) while combined RT and AE produced a 2.48 ml kg−1 min−1 increase in \( \dot{\mathrm{V}}{\mathrm{O}}_2 \); I 2 = 69%) compared to control group. Comparison among the three forms of exercise revealed similar effects on \( \dot{\mathrm{V}}{\mathrm{O}}_2 \) peak (P = 0.84 and 1.00, respectively; I 2 = 0%). AE was associated with a greater gain in LVEF (3.15%; P < 0.00001, I 2 = 17%) compared to RT alone or combined exercise which produced similar gains compared to control groups. Subgroup analysis revealed that AE reduced LVEDV (− 10.21 ml; P = 0.007, I 2 = 0%), while RT and combined RT and AE had no effect on LVEDV compared with control participants. RT results in a greater gain in \( \dot{\mathrm{V}}{\mathrm{O}}_2 \) peak, and induces no deleterious effects on cardiac function in HF patients.

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Abbreviations

HR:

Heart rate

HFrEF:

Heart failure with reduced ejection fraction

LVEDV:

Left ventricular end diastolic volume

LVEF:

Left ventricular ejection fraction

PRISMA:

Preferred reporting items for systematic reviews and meta-analyses

MR:

Maximal repetition

RT:

Resistance training

AE:

Aerobic exercise

\( \dot{\mathrm{V}}{\mathrm{O}}_2 \) peak :

Peak oxygen uptake

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Funding

This study was funded by grants from CNPq and CAPES, Brasilia, DF, Brazil.

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Authors and Affiliations

  1. Health Sciences and Technology and Rehabilitation Sciencies Program, University of Brasilia, Centro Metropolitano, Conjunto A – Lote 01 – Ceilândia, Brasília, DF, 72220-900, Brazil

    Francisco V. Santos, Gaspar R. Chiappa, Sergio Henrique Rodolpho Ramalho, Alexandra Correa Gervazoni Balbuena de Lima, Fausto Stauffer Junqueira de Souza, João Luiz Quagliotti Durigan & Gerson Cipriano Jr

  2. Cancer Institute of Sao Paulo, Sao Paulo, Brazil

    Francisco V. Santos

  3. Sarah Network of Rehabilitation Hospitals, Brasilia, Brazil

    Sergio Henrique Rodolpho Ramalho

  4. Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA

    Lawrence P. Cahalin

  5. Department of Medicine, Division of Molecular Medicine, University of Sao Paulo School of Medicine, Sao Paulo, Brazil

    Isac de Castro

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  1. Francisco V. Santos
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  6. Lawrence P. Cahalin
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  7. João Luiz Quagliotti Durigan
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  8. Isac de Castro
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  9. Gerson Cipriano Jr
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Correspondence to Gerson Cipriano Jr.

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Conflict of interest

Author Francisco V. Santos declares that he has no conflict of interest.

Author Gaspar R. Chiappa declares that he has no conflict of interest.

Author Sergio Henrique Rodolpho Ramalho declares that he has no conflict of interest.

Author Alexandra Correa Gervazoni Balbuena de Lima declares that she has no conflict of interest.

Author Fausto Stauffer Junqueira de Souza declares that he has no conflict of interest.

Author Lawrence P. Cahalin declares that he has no conflict of interest.

Author João Luiz Quagliotti Durigan declares that he has no conflict of interest.

Author Isac de Castro declares that he has no conflict of interest.

Author Gerson Cipriano Jr. declares that he has no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Santos, F.V., Chiappa, G.R., Ramalho, S.H.R. et al. Resistance exercise enhances oxygen uptake without worsening cardiac function in patients with systolic heart failure: a systematic review and meta-analysis. Heart Fail Rev 23, 73–89 (2018). https://doi.org/10.1007/s10741-017-9658-8

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  • DOI: https://doi.org/10.1007/s10741-017-9658-8

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