Guo Xiaozhen, Si Yanran, Liu Hairong, Yu Ling
Department of Physical Education, Tongji University, 200092 Shanghai, China.
Physical Education Department of Shanghai International Studies University, 201620 Shanghai, China.
Rev Cardiovasc Med. 2024 Aug 21;25(8):296. doi: 10.31083/j.rcm2508296. eCollection 2024 Aug.
This meta-analysis aimed to evaluate the impact of aerobic exercise on Peak VO (Oxygen Consumption) in postoperative patients with congenital heart disease (CHD). Besides this, we also tried to discover whether the improvement was influenced by patient ages, modes of supervision, types of exercise, the total dose of exercise, intervention periods, and types of CHD.
Following the Population Intervention Comparison Outcome Study Design (PICOS) principle, a comprehensive search of the PubMed, Web of Science, Embase and Cochrane Library databases was conducted for randomized controlled trials (RCTs) evaluating the intervention effects of aerobic exercise on cardiopulmonary function in postoperative CHD patients until December 2023. This meta-analysis and publication bias tests were conducted using Stata 17.0, and the mean differences (MDs) with 95% confidence intervals (CIs) were used as effect sizes in statistics.
A total of 15 RCTs (762 cases) were included in this meta-analysis, with 407 cases in the experimental group and 355 cases in the control group. Meta-analysis showed that aerobic exercise had a positive effect on Peak VO in postoperative CHD patients (MD = 2.14, 95% CI (1.34, 2.94), 0.00001, I = 36%). The analysis of subgroups showed that intervention effects of aerobic exercise were superior to the control group when patients were 18 years old (MD = 2.53, 0.00001), 18 years old (MD = 1.63, = 0.01), under supervision (MD = 2.23, 0.00001), unsupervised (MD = 2.06, 0.00400), performing aerobic exercise (MD = 1.87, = 0.0003), performing aerobic exercise combined with resistance training (MD = 2.57, 0.00010), with a total dose of exercise 1440 minutes (MD = 2.45, 0.00010), with the intervention period of 10-12 weeks (MD = 2.31, 0.00001), with that 12 weeks (MD = 1.97, = 0.00300), or with mixed types of CHD (MD = 2.34, 0.00001).
This meta-analysis did not deduct points for limitations, inconsistency, indirectness, imprecision, or publication bias, so the quality of evidence was graded as high. Aerobic exercise has a significantly positive impact on improving Peak VO in postoperative CHD patients. Moreover, it was found that for patients aged 18 and above, supervised aerobic exercise combined with resistance training, implemented for 10-12 weeks with a total dose of exercise 1440 minutes, had a better intervention effect on Peak VO. This finding provided evidence-based medicine for the exercise rehabilitation of postoperative CHD patients, and explored the optimal exercise prescription for clinical practice as well.
Registered on INPLASY No.202440016 (https://inplasy.com).
本荟萃分析旨在评估有氧运动对先天性心脏病（CHD）术后患者峰值摄氧量（VO，氧气消耗量）的影响。此外，我们还试图探究这种改善是否受患者年龄、监督方式、运动类型、运动总剂量、干预期以及CHD类型的影响。
遵循人群干预对照结局研究设计（PICOS）原则，对PubMed、Web of Science、Embase和Cochrane图书馆数据库进行全面检索，以查找评估有氧运动对CHD术后患者心肺功能干预效果的随机对照试验（RCT），检索截至2023年12月。本荟萃分析和发表偏倚检验使用Stata 17.0进行，统计中效应量采用具有95%置信区间（CI）的平均差（MD）。
本荟萃分析共纳入15项RCT（762例），其中试验组407例，对照组355例。荟萃分析表明，有氧运动对CHD术后患者的峰值VO有积极影响（MD = 2.14，95%CI（1.34，2.94），P < 0.00001，I² = 36%）。亚组分析显示，当患者年龄≥18岁（MD = 2.53，P < 0.00001）、<18岁（MD = 1.63，P = 0.01）、接受监督（MD = 2.23，P < 0.00001）、无监督（MD = 2.06，P = 0.00400）、进行有氧运动（MD = 1.87，P = 0.0003）、进行有氧运动联合抗阻训练（MD = 2.57，P = 0.00010）、运动总剂量≥1440分钟（MD = 2.45，P = 0.00010）、干预期为10 - 12周（MD = 2.31，P < 0.00001）、>12周（MD = 1.97，P = 0.00300）或CHD混合型（MD = 2.34，P < 0.00001）时，有氧运动的干预效果优于对照组。
本荟萃分析在局限性、不一致性、间接性、不精确性或发表偏倚方面未扣分，因此证据质量被评为高等级。有氧运动对改善CHD术后患者的峰值VO有显著积极影响。此外，研究发现对于18岁及以上患者，进行10 - 12周、运动总剂量≥1440分钟的有监督有氧运动联合抗阻训练，对峰值VO的干预效果更佳。这一发现为CHD术后患者的运动康复提供了循证医学依据，也为临床实践探索了最佳运动处方。
在INPLASY注册号为202440016（https://inplasy.com）注册。
