Document Detail


Exercise training for systolic heart failure: Cochrane systematic review and meta-analysis.
MedLine Citation:
PMID:  20494922     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To determine the effect of exercise training on clinical events and health-related quality of life (HRQoL) of patients with systolic heart failure.
METHODS AND RESULTS: We searched electronic databases including Medline, EMBASE, and Cochrane Library up to January 2008 to identify randomized controlled trials (RCTs) comparing exercise training and usual care with a minimum follow-up of 6 months. Nineteen RCTs were included with a total of 3647 patients, the majority of whom were male, low-to-medium risk, and New York Heart Association class II-III with a left ventricular ejection fraction of <40%. There was no significant difference between exercise and control in short-term (<or=12 months) or longer-term all-cause mortality or overall hospital admissions. Heart failure-related hospitalizations were lower [relative risk: 0.72, 95% confidence interval (CI): 0.52-0.99] and HRQoL improved (standardized mean difference: -0.63, 95% CI: -0.80 to -0.37) with exercise therapy. Any effect of cardiac exercise training on total mortality and HRQoL was independent of degree of left ventricular dysfunction, type of cardiac rehabilitation, dose of exercise intervention, length of follow-up, trial quality, and trial publication date.
CONCLUSION: Compared with usual care, in selected heart failure patients, exercise training reduces heart failure-related hospitalizations and results in clinically important improvements in HRQoL. High-quality RCT and cost-effectiveness evidence is needed for the effect of exercise training in community-based settings and in more severe heart failure patients, elderly people, and women.
Authors:
Edward J Davies; Tiffany Moxham; Karen Rees; Sally Singh; Andrew J S Coats; Shah Ebrahim; Fiona Lough; Rod S Taylor
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2010-05-21
Journal Detail:
Title:  European journal of heart failure     Volume:  12     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-25     Completed Date:  2010-10-01     Revised Date:  2011-08-01    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  706-15     Citation Subset:  IM    
Affiliation:
Cardiothoracic Department, Plymouth Hospitals NHS Trust, Terrance Lewis Building, 9th Floor, Derriford Hospital, Plymouth Hospitals NHS Trust, Derriford Road, Crownhill, Plymouth, Devon PL6 8DH, UK. dreddavies@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Exercise Therapy
Exercise Tolerance
Female
Heart Failure, Systolic / rehabilitation*
Hospitalization / statistics & numerical data
Humans
Male
Middle Aged
Quality of Life
Randomized Controlled Trials as Topic
Ventricular Dysfunction, Left / epidemiology,  rehabilitation
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