Li Hu, Liu Yingxue, Liu Yu, Xu Zhichao, Pan Pengchao, Zeng Lijun
Department of Cardiology, The First Naval Hospital, Southern Theater Command of PLA, No.10 Haibin Avenue Middle, Zhanjiang, 524005, China.
Outpatient Department, The First Naval Hospital, Southern Theater Command of PLA, Zhanjiang, 524005, China.
BMC Cardiovasc Disord. 2025 Mar 25;25(1):217. doi: 10.1186/s12872-025-04649-0.
Heart failure with preserved ejection fraction (HFpEF) is increasingly prevalent and poses significant treatment challenges due to its complex pathophysiology. Exercise training has emerged as a promising non-pharmacological intervention to improve outcomes in HFpEF patients. This study aims to evaluate the effect of exercise training on exercise tolerance, cardiac function and quality of life in HFpEF patients.
Through systematic review and meta-analysis, major databases were scoured for randomized controlled trials (RCTs) evaluating the influence of exercise training on HFpEF patients. Data on exercise tolerance, cardiac function parameters, and quality of life were extracted. The quality of the studies was assessed using the Cochrane Collaboration's risk of bias tool. Statistical analyses were performed using Review Manager 5.4, with mean differences (MD) or standardized mean differences (SMD) and 95% confidence intervals (CIs) calculated for continuous variables.
Seven RCTs encompassing 470 participants met the inclusion criteria. Exercise training significantly improved exercise tolerance as measured by the 6-Minute Walk Test (P < 0.01) and peak VO₂ (P = 0.03). No significant effects were observed on cardiac function parameters, including the E/A ratio, E/e' ratio, and LVEF. Total quality of life was similar between exercise and control groups, but significantly enhanced in physical components about quality of life was observed in the exercise group (P = 0.03). There were no significant differences between high-intensity interval training (HIIT) and moderate continuous training (MCT) in improving exercise tolerance, cardiac function, or quality of life.
Exercise training effectively enhances exercise tolerance and physical quality of life in patients with HFpEF, without significantly impacting cardiac function parameters. HIIT and MCT has similar effect in HFpEF patients. These findings support the incorporation of exercise training into the management strategies for HFpEF patients to improve functional outcomes and quality of life.
射血分数保留的心力衰竭（HFpEF）日益普遍，因其复杂的病理生理学给治疗带来了重大挑战。运动训练已成为一种有前景的非药物干预措施，可改善HFpEF患者的预后。本研究旨在评估运动训练对HFpEF患者运动耐量、心脏功能和生活质量的影响。
通过系统评价和荟萃分析，在主要数据库中检索评估运动训练对HFpEF患者影响的随机对照试验（RCT）。提取运动耐量、心脏功能参数和生活质量的数据。使用Cochrane协作网的偏倚风险工具评估研究质量。使用Review Manager 5.4进行统计分析，计算连续变量的平均差（MD）或标准化平均差（SMD）以及95%置信区间（CI）。
7项RCT共纳入470名参与者，符合纳入标准。运动训练通过6分钟步行试验（P < 0.01）和峰值VO₂（P = 0.03）测量，显著提高了运动耐量。在包括E/A比值、E/e'比值和左心室射血分数（LVEF）在内的心脏功能参数上未观察到显著影响。运动组和对照组的总体生活质量相似，但运动组在生活质量的身体方面显著提高（P = 0.03）。高强度间歇训练（HIIT）和中等强度持续训练（MCT）在提高运动耐量、心脏功能或生活质量方面无显著差异。
运动训练可有效提高HFpEF患者的运动耐量和身体生活质量，而对心脏功能参数无显著影响。HIIT和MCT对HFpEF患者有相似效果。这些发现支持将运动训练纳入HFpEF患者的管理策略，以改善功能预后和生活质量。
