Siyah Tugba, Yagli Naciye Vardar, Ertugrul Ilker, Aykan Hayrettin Hakan, Saglam Melda
Hacettepe University, Faculty of Physiotherapy and Rehabilitation, Ankara - Turquia.
Hacettepe University, Faculty of Medicine, Department of Pediatric Cardiology, Ankara - Turquia.
Arq Bras Cardiol. 2024 Nov;121(12):e20240294. doi: 10.36660/abc.20240294.
Current guidelines advise exercise for most congenital heart disease patients (CHD). However, physical activity remains low in CHD individuals, with limited research on exercise's effects in adults.
The aim of this study is to evaluate the safety and efficacy of exercise training on exercise capacity and quality of life in adult congenital heart disease (ACHD) patients.
We searched PubMed/Medline, Cochrane Library, Web of Science, and Scopus through December 2022 for randomized controlled trials assessing aerobic and resistance training effects on exercise capacity and quality of life in ACHD. Out of 3,517 citations, ten eligible articles were included.
Meta-analysis of the included randomized controlled trials (286 participants) found no significant change in peak oxygen consumption or quality of life in ACHD with exercise training (pooled mean difference = 0.33 ml/kg/min [95% CI, -0.88 to 1.54 ml/kg/min]; p = 0.60; I2= 3%). However, the increase in maximum workload was significant (pooled mean difference = 8.86 watts [95% CI, 0.78 to 16.93], p = 0.03, I2 = 0%).
Our review confirms that exercise training increases the maximum workload in ACHD patients. However, the lack of a standardized protocol among exercise interventions in this population may have contributed to the absence of a significant change in peak VO2 and quality of life observed in the conducted studies. The heterogeneity of exercise programs could be a contributing factor to the inconsistency of the results. In this context, the implementation of standardized exercise protocols in future research, particularly with larger sample sizes, is crucial to enhance the comparability of outcomes. Well-designed randomized controlled trials studying structured exercise training in ACHD patients will provide clearer insights.
当前指南建议大多数先天性心脏病患者（CHD）进行运动。然而，先天性心脏病患者的体力活动水平仍然较低，且针对运动对成年人影响的研究有限。
本研究旨在评估运动训练对成年先天性心脏病（ACHD）患者运动能力和生活质量的安全性和有效性。
我们检索了截至2022年12月的PubMed/Medline、Cochrane图书馆、科学网和Scopus，以查找评估有氧运动和抗阻训练对ACHD患者运动能力和生活质量影响的随机对照试验。在3517条引用文献中，纳入了10篇符合条件的文章。
对纳入的随机对照试验（286名参与者）进行的荟萃分析发现，运动训练对ACHD患者的峰值耗氧量或生活质量没有显著变化（合并平均差异 = 0.33毫升/千克/分钟 [95%置信区间，-0.88至1.54毫升/千克/分钟]；p = 0.60；I² = 3%）。然而，最大工作量的增加是显著的（合并平均差异 = 8.86瓦 [95%置信区间，0.78至16.93]，p = 0.03，I² = 0%）。
我们的综述证实运动训练可提高ACHD患者的最大工作量。然而，该人群运动干预措施缺乏标准化方案可能导致在已开展的研究中未观察到峰值VO₂和生活质量有显著变化。运动项目的异质性可能是结果不一致的一个因素。在此背景下，在未来研究中实施标准化运动方案，尤其是样本量更大的研究，对于提高结果的可比性至关重要。精心设计的研究ACHD患者结构化运动训练的随机对照试验将提供更清晰的见解。
