Key result
Exercise therapy increases 6MWD by ~26 meters vs conventional treatment in valvular heart disease.
Why the study?
Physical inactivity affects patients with valvular heart disease, especially post-surgery, but data on exercise effects from large multicentre RCTs are lacking.
Does exercise therapy improve cardiopulmonary function and quality of life in patients with valvular heart disease?
Meta-Analysis (n=1,520)
Does exercise therapy improve cardiopulmonary function and quality of life in patients with valvular heart disease?
Exercise training significantly improves functional capacity, left ventricular ejection fraction, and quality of life in patients with valvular heart disease.
Supports exercise to boost cardiopulmonary function and QoL in VHD; extends sparse RCT data but requires multicenter trials before broad adoption.
Background: Valvular heart disease (VHD) is a type of cardiovascular disease with abnormal heart valve structure and/or function and a rapidly growing cause of global cardiovascular morbidity and mortality. Physical inactivity is a problem for patients with VHD, especially after surgery. However, there is no data on the effects of exercise on VHD from large multicentre randomised controlled trials (RCTs). Therefore, we conducted a systematic review and meta-analysis to provide a comprehensive analysis of small RCTs to evaluate the effects of exercise on cardiopulmonary function in patients with VHD and provide an evidence-based medicine basis for developing and guiding the clinical application of exercise in patients with VHD. Methods: We conducted a systematic review and meta-analysis of RCTs. We systematically searched electronic databases (PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure [CNKI], China Science and Technology Journal Database [VIP], WanFang Database, and SinoMed [CBM]) for all studies on exercise and VHD from their inception to January 2023. The quality of included studies was assessed using the Cochrane risk-of-bias tool. The primary outcomes were the six-minute walk test distance (6MWD), left ventricular ejection fraction (LVEF), and short-form 36-item health survey (SF-36). Results: This systematic review included 22 RCTs with 1520 subjects (869 men and 651 women). The meta-analysis results showed that exercise significantly improved exercise capacity measured by the 6MWD (mean difference [MD] = 25.54, 95% confidence interval [CI] = 19.98–31.11, I2 = 0%, p < 0.00001), LVEF (MD = 6.20, 95% CI = 4.76–7.65, I2 = 66%, p < 0.00001), and quality of life measured by the SF-36 (physical function: MD = 3.42, 95% CI = 2.12–4.72, I2 = 12%, p < 0.00001; mental health: MD = 3.86, 95% CI = 0.52–7.20, I2 = 68%, p = 0.020; social function: MD = 2.30, 95% CI = 0.64–3.97, I2 = 45%, p = 0.007; bodily pain: MD = 2.60, 95% CI = 0.83–4.37, I2 = 22%, p = 0.004) in patients with VHD compared to healthy controls. Conclusions: This study suggests that exercise can significantly improve cardiopulmonary function, enhance physical and social function, reduce bodily pain, and potentially improve mental health in patients with VHD, providing an evidence-based basis for better recovery in patients with VHD.
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Zeng et al. (2023) conducted a meta-analysis in Valvular heart disease (VHD) (n=1,520). Exercise therapy vs. Conventional treatment without an exercise program was evaluated on Six-minute walk test distance (6MWD) (MD 25.54, 95% CI 19.98-31.11, p=<0.00001).
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