Ashfaq Zarbakhta, Zahir Fatima, Masoodi Aaliyah, Khan Mohsin, Anthony Nouman, Vinayagamoorthy Nikesh, Mamadaminova Marhabo, Manzoor Ammara, Saleem Arfa, Kolanu Nikhil Deep
Medicine, Rehman Medical Institute, Peshawar, PAK.
Medicine, Zaheer Hospital, Kamalia, PAK.
Cureus. 2025 May 3;17(5):e83396. doi: 10.7759/cureus.83396. eCollection 2025 May.
This systematic review evaluates the role of exercise-based rehabilitation in heart failure with preserved ejection fraction (HFpEF) by synthesizing findings from high-quality meta-analyses. A comprehensive literature search was conducted following PRISMA guidelines, identifying six meta-analyses that examined the effects of structured exercise programs, including aerobic training, resistance training, inspiratory muscle training, and supervised rehabilitation. The findings consistently demonstrate significant improvements in functional capacity, with notable increases in peak oxygen uptake (VO₂ max) and 6-minute walk test (6MWT) distance. Quality of life measures, including the Minnesota Living With Heart Failure Questionnaire (MLWHFQ) and the SF-36 physical function domain, also showed meaningful enhancements. However, the impact of exercise on diastolic function and left ventricular remodeling remains inconclusive, with limited improvements in echocardiographic parameters such as the E/A ratio and E/e' ratio. The study selection process ensured the inclusion of only meta-analyses synthesizing randomized controlled trials (RCTs), providing a high level of evidence while minimizing biases associated with individual trials. Despite variability in exercise modalities, intervention duration, and patient characteristics, the overall findings support the integration of structured exercise programs into HFpEF management strategies. Further research is needed to explore long-term myocardial adaptations, optimal training regimens, and potential synergies between exercise therapy and pharmacological interventions to enhance clinical outcomes.
本系统评价通过综合高质量荟萃分析的结果，评估了基于运动的康复在射血分数保留的心力衰竭（HFpEF）中的作用。按照PRISMA指南进行了全面的文献检索，确定了六项荟萃分析，这些分析考察了结构化运动计划的效果，包括有氧运动训练、抗阻训练、吸气肌训练和监督康复。研究结果一致表明，功能能力有显著改善，峰值摄氧量（VO₂ max）和6分钟步行试验（6MWT）距离显著增加。生活质量指标，包括明尼苏达心力衰竭生活问卷（MLWHFQ）和SF-36身体功能领域，也显示出有意义的改善。然而，运动对舒张功能和左心室重构的影响仍不确定，超声心动图参数如E/A比值和E/e'比值仅有有限改善。研究选择过程确保仅纳入综合随机对照试验（RCT）的荟萃分析，提供了高水平的证据，同时将与单个试验相关的偏倚降至最低。尽管运动方式、干预持续时间和患者特征存在差异，但总体研究结果支持将结构化运动计划纳入HFpEF管理策略。需要进一步研究来探索长期心肌适应性、最佳训练方案以及运动疗法与药物干预之间的潜在协同作用，以改善临床结局。
