Impact of Long-Term Exercise-Based Cardiac Rehabilitation in Patients With Chronic Heart Failure ― A Systematic Review and Meta-Analysis ―
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- Yamamoto Shuhei
- Department of Rehabilitation, Shinshu University Hospital
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- Okamura Masatsugu
- Berlin Institute of Health Center for Regenerative Therapies, Charité–Universitätsmedizin Berlin
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- Akashi Yoshihiro J.
- Department of Cardiology, St. Marianna University School of Medicine
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- Tanaka Shinya
- Department of Rehabilitation, Nagoya University Hospital
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- Shimizu Masashi
- Department of Rehabilitation, Osaka Metropolitan University Hospital
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- Tsuchikawa Yohei
- Department of Rehabilitation, Nagoya University Hospital
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- Ashikaga Kohei
- Department of Sports Medicine, St. Marianna University School of Medicine
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- Kamiya Kentaro
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University
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- Kato Yuko
- Department of Cardiology, The Cardiovascular Institute
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- Nakayama Atsuko
- Department of Cardiology, Sakakibara Heart Institute
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- Makita Shigeru
- Saitama Medical University International Medical Center
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- Isobe Mitsuaki
- Sakakibara Heart Institute
Abstract
<p>Background: This study aimed to clarify the effects of exercise-based cardiac rehabilitation (CR) on patients with heart failure.</p><p>Methods and Results: Patients were divided into groups according to intervention duration (<6 and ≥6 months). We searched for studies published up to July 2023 in Embase, MEDLINE, PubMed, and the Cochrane Library, without limitations on data, language, or publication status. We included randomized controlled trials comparing the efficacy of CR and usual care on mortality, prehospitalization, peak oxygen uptake (V̇O2), and quality of life. Seventy-two studies involving 8,495 patients were included in this review. It was found that CR reduced the risk of rehospitalization for any cause (risk ratio [RR] 0.80; 95% confidence interval [CI] 0.70–0.92) and for heart failure (RR 0.88; 95% CI 0.78–1.00). Furthermore, CR was found to improve exercise tolerance (measured by peak V̇O2and the 6-min walk test) and quality of life. A subanalysis performed based on intervention duration (<6 and ≥6 months) revealed a similar trend.</p><p>Conclusions: Our meta-analysis showed that although CR does not reduce mortality, it is effective in reducing rehospitalization rates and improving exercise tolerance and quality of life, regardless of the intervention duration.</p>
Journal
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- Circulation Journal
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Circulation Journal advpub (0), 2024-01-12
The Japanese Circulation Society