Effects of different exercise modalities on inhibiting left ventricular pathological remodeling in patients with heart failure with reduced ejection fraction: A systematic review and network meta-analysis

• Published in: Life sciences (1973) 2023-04, Vol.319, p.121511-121511, Article 121511
• Main Authors: Wang, Tao, Zhang, Lin, Cai, Mengxin, Tian, Zhenjun
• Format: Article
• Language: English
• Subjects: Cardiopulmonary function; Exercise; Exercise - physiology; Exercise Tolerance; Heart Failure - therapy; Heart failure with reduced ejection fraction; Humans; Left ventricular pathological remodeling; Network Meta-Analysis; Randomized Controlled Trials as Topic; Stroke Volume - physiology; Ventricular Dysfunction, Left; Ventricular Function, Left - physiology; Ventricular Remodeling
• ISSN: 0024-3205; 1879-0631
• DOI: 10.1016/j.lfs.2023.121511

To evaluate the effects of different exercise training modalities on inhibiting the left ventricular pathological remodeling in patients with heart failure with reduced ejection fraction (HFrEF) and screen out the optimal exercise modality. We performed a network meta-analysis based on the Frequentist model. Random-effect meta-analyses were used to estimate mean differences (MD) and 95 % confidence intervals. 25 randomized controlled trials (1284 patients) were enrolled in this study. Results revealed that: high-intensity interval training had the best effect in improving left ventricular ejection fraction (p-score = 0.93, MD: 6.44 (3.61 to 9.28)), reducing left ventricular end-diastolic diameter (p-score = 0.97, MD: −6.73 (−10.27 to −3.19)) and left ventricular end-systolic diameter (p-score = 0.97, MD: −9.33 (−14.90 to −3.76)). Combined aerobic training with resistance training and inspiratory muscle training had the best effect in improving maximal oxygen consumption (p-score = 0.90, MD: 5.19 (3.12 to 7.25)). Current evidence revealed that exercise training could effectively inhibit left ventricular pathological remodeling in patients with HFrEF. For efficacy, high-intensity interval training may have greater potential. [Display omitted] •This article used network meta-analysis to make up for traditional meta-analysis.•This article compared 10 commonly used training modalities for patients with heart failure with reduced ejection fraction.•High intensity interval training maybe the optimal exercise for patients with heart failure with reduced ejection fraction.