Liu Yi-Tian, Deng Chang-Jiang, Yang Feng-Li, Yang Hao-Yue, Wang Zhi-Long, Yin Xin, Pan Ying, Wu Ting-Ting, Xie Xiang
Department of Clinical Medicine, Xinjiang Medical University, Urumqi, China.
Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Cardiovasc Diagn Ther. 2025 Jun 30;15(3):526-538. doi: 10.21037/cdt-2024-698. Epub 2025 Jun 26.
Cardiac rehabilitation (CR) has been shown to be an effective treatment for patients with heart failure (HF). However, the effect of different modes of CR delivery on HF remains unclear. The purpose of this study is to perform a large-scale pairwise and network meta-analysis (NMA) on the impact of various exercise types on patients with HF using multiple indicators.
Randomized controlled trials (RCTs) published between 2000 and October 2023 were systematically searched in PubMed (Medline), the Cochrane Library and Web of Science. Statistical analysis was performed by STATASE16 with the network pack. The primary outcomes focused on functional capacity and health-related quality of life (QoL), such as peak VO, six-minute walk test (6MWT), maximum workload, left ventricular ejection fraction (LVEF), maximum heart rate (MHR), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores. All relevant studies reported well-defined or accessible exposures and presented clear data on any one or more of the six items above before and after exercise rehabilitation.
In total, 122 RCTs were ultimately included in the final analysis. Pairwise analyses revealed aerobic training (AT) can improve peak VO (2.49 mL/kg/min) and LVEF (2.97%). High-intensity interval training (HIIT) was associated with an improvement in peak VO (3.91 mL/kg/min), LVEF (6.68%), 6MWT (65.4 m) and MLHFQ score (-10.34). As shown in the NMA, the rank order of effectiveness based on the surface under the cumulative ranking curve (SUCRA) values for peak VO, was HIIT (SUCRA: 90.8%), strength training (ST) (74.7%), AT (64.4%), combined training (CT) (41.7%) and inspiratory muscle training (IMT) (18.3%). The order of effectiveness for LVEF based on SCURA values was HIIT (90.5%), AT (77.8%), CT (50.3%), ST (49.9%) and IMT (7.7%).
Various types of exercise, especially HIIT, can improve QoL, cardiac function, LVEF, and exercise tolerance in patients with HF. The results of this analysis should inform future exercise guideline personalized recommendations and prescriptions for HF patients.
心脏康复（CR）已被证明是治疗心力衰竭（HF）患者的有效方法。然而，不同的心脏康复模式对心力衰竭的影响仍不明确。本研究的目的是使用多个指标对各种运动类型对心力衰竭患者的影响进行大规模的成对和网状荟萃分析（NMA）。
在PubMed（Medline）、Cochrane图书馆和科学网中系统检索2000年至2023年10月发表的随机对照试验（RCT）。使用网络数据包通过STATASE16进行统计分析。主要结局集中在功能能力和健康相关生活质量（QoL）上，如峰值VO、六分钟步行试验（6MWT）、最大工作量、左心室射血分数（LVEF）、最大心率（MHR）以及明尼苏达心力衰竭生活问卷（MLHFQ）评分。所有相关研究均报告了明确界定或可获取的暴露情况，并在运动康复前后提供了上述六项中的任何一项或多项的清晰数据。
最终共有122项RCT纳入最终分析。成对分析显示，有氧训练（AT）可提高峰值VO（2.49 mL/kg/min）和LVEF（2.97%）。高强度间歇训练（HIIT）与峰值VO（3.91 mL/kg/min）、LVEF（6.68%）、6MWT（65.4 m）和MLHFQ评分（-10.34）的改善相关。如网状荟萃分析所示
