van Tol Benno A F, Huijsmans Rosalie J, Kroon Dineke W, Schothorst Maaike, Kwakkel Gert
Department of Physical Therapy, VU University Medical Center, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands.
Eur J Heart Fail. 2006 Dec;8(8):841-50. doi: 10.1016/j.ejheart.2006.02.013. Epub 2006 May 18.
Despite major advances in pharmacological treatment of chronic heart failure (CHF), a number of patients still suffer from dyspnoea, fatigue, diminished exercise capacity and poor quality of life. It is in this context that exercise training is being intensively evaluated for any additional benefit in the treatment of CHF.
To determine the effect of exercise training in patients with CHF on cardiac performance, exercise capacity and health-related quality of life. A meta-analysis was performed to obtain this goal.
After including 35 randomised controlled trials, the methodological quality of each study was assessed, summary effect sizes (SESs) and the concomitant 95% confidence intervals (95% CI) were calculated for each outcome. Quantitative analysis showed statistically significant SESs, at rest, for diastolic blood pressure and end-diastolic volume. During maximal exercise, significant SESs were found for systolic blood pressure, heart rate, cardiac output, peak oxygen uptake, anaerobic threshold and 6-min walking test. The Minnesota Living with Heart Failure Questionnaire improved by an average of 9.7 points.
Exercise training has clinically important effects on exercise capacity and HRQL, and may have small positive effects on cardiac performance during exercise.
尽管慢性心力衰竭（CHF）的药物治疗取得了重大进展，但仍有许多患者存在呼吸困难、疲劳、运动能力下降和生活质量差等问题。正是在这种背景下，运动训练正在被深入评估对CHF治疗的任何额外益处。
确定CHF患者进行运动训练对心脏功能、运动能力和健康相关生活质量的影响。为此进行了一项荟萃分析。
纳入35项随机对照试验后，评估了每项研究的方法学质量，计算了每个结局的汇总效应量（SES）及相应的95%置信区间（95%CI）。定量分析显示，静息时舒张压和舒张末期容积的SES具有统计学意义。在最大运动时，收缩压、心率、心输出量、峰值摄氧量、无氧阈值和6分钟步行试验的SES也具有统计学意义。明尼苏达心力衰竭生活问卷平均提高了9.7分。
运动训练对运动能力和健康相关生活质量有临床重要影响，对运动期间的心脏功能可能有微小的积极影响。
