Zhang Rongxiang, Zhu Chenyang, Chen Shiqi, Tian Feng, Chen Yuan
Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China.
School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Clin Cardiol. 2025 Mar;48(3):e70117. doi: 10.1002/clc.70117.
This systematic review and evidence mapping study aims to assess the effects of exercise-based cardiac rehabilitation on clinical outcomes in patients after heart valve surgery. By consolidating and visualizing existing evidence, the study seeks to identify gaps in knowledge, evaluate the quality and breadth of current research, and provide guidance for clinical practice and future research. The evidence mapping will highlight under-researched areas and inform healthcare providers on effective strategies to enhance postoperative recovery.
A comprehensive search was performed across multiple databases, including PubMed, Embase, Cochrane CENTRAL, Web of Science, CNKI, and Wanfang, up to May 2024. Two reviewers independently screened the articles, extracted relevant data, and assessed study quality. Study characteristics and outcomes were visualized using bubble plots.
Ten systematic reviews/meta-analyses met the inclusion criteria. Based on AMSTAR-2, two were rated "high quality," two "low quality," and six "very low quality." Using the GRADE system, of the 48 pieces of evidence across 10 outcomes, 1 was "high quality," 8 "moderate," 19 "low," and 20 "very low."
Current evidence indicates that exercise-based cardiac rehabilitation can enhance physical capacity, left ventricular ejection fraction, peak oxygen uptake, and daily living activities in heart valve surgery patients. However, more large-scale, high-quality studies are needed to verify its effects on all-cause mortality, quality of life, adverse events, return to work, and emotional health.
本系统评价和证据图谱研究旨在评估基于运动的心脏康复对心脏瓣膜手术后患者临床结局的影响。通过整合和可视化现有证据，该研究旨在找出知识空白，评估当前研究的质量和广度，并为临床实践和未来研究提供指导。证据图谱将突出研究不足的领域，并为医疗保健提供者提供关于促进术后恢复的有效策略的信息。
截至2024年5月，在多个数据库中进行了全面检索，包括PubMed、Embase、Cochrane CENTRAL、Web of Science、中国知网和万方。两名评审员独立筛选文章、提取相关数据并评估研究质量。使用气泡图可视化研究特征和结果。
10项系统评价/荟萃分析符合纳入标准。根据AMSTAR-2，2项被评为“高质量”，2项“低质量”，6项“极低质量”。使用GRADE系统，在10个结局的48条证据中，1条为“高质量”，8条“中等质量”，19条“低质量”，20条“极低质量”。
目前的证据表明，基于运动的心脏康复可以提高心脏瓣膜手术患者的身体能力、左心室射血分数、峰值摄氧量和日常生活活动能力。然而，需要更多大规模、高质量的研究来验证其对全因死亡率、生活质量、不良事件、重返工作岗位和情绪健康的影响。
