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Does exercise training improve exercise tolerance, quality of life, and echocardiographic parameters in patients with heart failure with preserved ejection fraction? A systematic review and meta-analysis of randomized controlled trials

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Abstract

Patients with heart failure with preserved ejection fraction (HFpEF) often experience dyspnea, decreased exercise tolerance, and decreased quality of life (QOL). Exercise training is a promising non-pharmacological treatment, with some improvement in exercise tolerance and QOL in HFpEF patients in randomized controlled trials (RCTs). We conducted a systematic review and meta-analysis of RCTs examining the effect of exercise therapy on exercise tolerance, QOL, and echocardiographic parameters in patients with HFpEF. Article database search of PubMed, Embase, and Cochrane Central Register of Controlled Trials identified 15 publications representing 579 unique patients. Results are presented as weighted mean difference (WMD) with 95% confidence intervals (CI). Exercise training (compared to control) demonstrated a significant improvement in exercise tolerance as measured by peak absolute VO2 (WMD [95% CI] = 164.67 [65.54, 263.79] mL/min), peak relative VO2 (WMD [95% CI] = 1.85 [0.98, 2.73] mL/min/kg), workload (WMD [95% CI] = 12.92 [4.67, 21.17] W), exercise time (WMD [95% CI] = 2.05 [1.57, 2.53] min), anaerobic threshold (WMD [95% CI] = 170.31 [35.40, 305.22] mL/min/kg), and 6-min walk test distance (WMD [95% CI] = 32.77 [20.72, 44.83] m); in QOL as measured by Short Form (SF-36) physical functioning domain (WMD [95% CI] = 9.95 [2.85, 17.05]) and SF-36 vitality domain (WMD [95% CI] = 6.24 [0.15, 12.34]); and in the echocardiographic measure of LVESD (WMD [95% CI] =  − 0.16 [− 0.28, − 0.04] cm). In conclusion, we found after systematic review and meta-analysis of RCTs that exercise therapy improves exercise tolerance and physical-related quality of life measures.

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Authors and Affiliations

  1. Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Billy Lin

  2. New York University Grossman School of Medicine, New York, NY, USA

    Billy Lin, Matthew Siskin, Binhuan Wang & Sundar Natarajan

  3. VA New York Harbor Healthcare System, New York, NY, USA

    Sundar Natarajan

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  1. Billy Lin
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  2. Matthew Siskin
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  3. Binhuan Wang
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  4. Sundar Natarajan
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Contributions

Conceptualization: BL and SN; methodology: BL, BW, and SN; formal analysis and investigation: BL, MS, BW, and SN; writing — original draft preparation: BL; writing — review and editing: BL, MS, BW, and SN.

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Correspondence to Billy Lin.

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Lin, B., Siskin, M., Wang, B. et al. Does exercise training improve exercise tolerance, quality of life, and echocardiographic parameters in patients with heart failure with preserved ejection fraction? A systematic review and meta-analysis of randomized controlled trials. Heart Fail Rev 28, 795–806 (2023). https://doi.org/10.1007/s10741-022-10285-z

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  • DOI: https://doi.org/10.1007/s10741-022-10285-z

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