Yang Chenyan, Wu Qian, Lv Qianyu, Hou Xinzheng, Ye Xuejiao, Yang Yingtian, Li Lanlan, Zuo Wenxi, Wang Shihan
Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.
Guang'anmen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Front Cardiovasc Med. 2024 Feb 23;11:1352643. doi: 10.3389/fcvm.2024.1352643. eCollection 2024.
It is advised that patients engage in physical activity to enhance their quality of life and achieve better results. The purpose of the current study was to measure the efficacy of exercise on the physical ability, cardiac function and cardiopulmonary fitness of patients with AF.
A comprehensive systematic literature search was performed in PubMed, Embase, and Web of Science from 1991 to 2023 for RCTs comparing physical exercise combined with AF routine treatments to routine treatments alone. The meta-analysis was conducted following PRISMA guidelines. Our main outcomes were physical ability (measured by the 6-min walk test, 6MWT), cardiac function (measured by left ventricular ejection fraction, LVEF) and cardiopulmonary fitness (measured by peak oxygen uptake and resting heart rate). Quality assessments were conducted using the Cochrane Collaboration tool.
Thirteen trials involving 672 patients met the criteria for analysis. The results showed that physical exercise increased physical ability by improving the 6MWT (m) performance (MD = 96.99, 95% CI: 25.55-168.43; = 2.66; = 0.008); and enhanced peak VO2 (ml/kg per min) (MD = 4.85, 95% CI: 1.55-8.14; = 2.89; = 0.004) while reducing resting heart rate (beats per minute, bpm) (MD = -6.14, 95% CI: -11.30 to -0.98; = 2.33; = 0.02). However, the results showed that regular exercise could improve LVEF (%) inpatients clinically, which had no statistic difference between experimental and control group (MD = 1.49, 95% CI: -0.25-3.24; = 1.68; = 0.09).
Our meta-analysis shows that physical exercise is an effective intervention to improve the exercise ability and cardiopulmonary fitness for AF patients. Meanwhile, we also do not exclude the positive effect of exercise on the improvement of cardiac function (LVEF) in patients with AF. To this end, doctors should consider the positive impact of exercise on patients and give advice on exercise limits in practical clinical practice.
建议患者进行体育活动以提高生活质量并取得更好的效果。本研究的目的是评估运动对房颤患者身体能力、心脏功能和心肺适能的疗效。
在1991年至2023年期间，在PubMed、Embase和Web of Science数据库中进行了全面的系统文献检索，以查找比较体育锻炼联合房颤常规治疗与单纯常规治疗的随机对照试验（RCT）。按照PRISMA指南进行荟萃分析。我们的主要结局指标为身体能力（通过6分钟步行试验（6MWT）测量）、心脏功能（通过左心室射血分数（LVEF）测量）和心肺适能（通过峰值摄氧量和静息心率测量）。使用Cochrane协作工具进行质量评估。
13项涉及672例患者的试验符合分析标准。结果显示，体育锻炼通过改善6MWT（米）表现提高了身体能力（MD = 96.99，95%CI：25.55 - 168.43；Z = 2.66；P = 0.008）；提高了峰值摄氧量（毫升/千克每分钟）（MD = 4.85，95%CI：1.55 - 8.14；Z = 2.89；P = 0.004），同时降低了静息心率（每分钟心跳次数，bpm）（MD = -6.14，95%CI：-11.30至-0.98；Z = 2.33；P = 0.02）。然而，结果显示，规律运动在临床上可改善患者的LVEF（%），但试验组与对照组之间无统计学差异（MD = 1.49，95%CI：-0.25 - 3.24；Z = 1.68；P = 0.09）。
我们的荟萃分析表明，体育锻炼是改善房颤患者运动能力和心肺适能的有效干预措施。同时，我们也不排除运动对改善房颤患者心脏功能（LVEF）的积极作用。为此，医生应考虑运动对患者的积极影响，并在实际临床实践中给出运动限度的建议。
