Key result
Inspiratory muscle training was the highest ranked exercise intervention for improving VO2 peak in HFpEF patients (SMD 3.6; 95% CI 2.3-4.8), followed by high-intensity interval training.
Why the study?
Exercise is important in HFpEF rehabilitation, but it is unclear which type of physical rehabilitation exercise is most effective for improving aerobic capacity.
Do different types of exercise interventions improve aerobic capacity in patients with HFpEF?
Meta-Analysis (n=720)
Do different types of exercise interventions improve aerobic capacity in patients with HFpEF?
Inspiratory muscle training, high-intensity interval training, and combined aerobic and resistance exercise significantly improve aerobic capacity in patients with HFpEF and should be considered in their rehabilitation care.
Answers are grounded in this paper and cite their sources.
Supports incorporating inspiratory muscle training into HFpEF rehabilitation; extends comparative evidence on exercise modalities.
Exercise is an important component of rehabilitation care for patients with heart failure with preserved ejection fraction (HFpEF). However, it is unclear which type of physical rehabilitation exercise is most effective. Thus, the aim of this study was to determine the relative effects of different types of exercise interventions on aerobic capacity measured by peak oxygen consumption (VO 2 peak; in mL/kg·min) in patients with HFpEF. We searched different electronic databases until December 2020 for randomized controlled trials that evaluated the effects of different types of exercise interventions on VO 2 peak of patients with HFpEF. Mean difference, standardized mean difference (SMD), and 95% confidence intervals (CIs) were calculated. Fixed and random-effects Bayesian network meta-analysis was used to compare the relative effectiveness of the different exercise interventions. Nineteen studies met the study criteria, including 720 patients. Comparing the physical rehabilitation interventions with usual care (control group), inspiratory muscle training was the highest ranked exercise intervention with an SMD of 3.6 mL/kg·min (95% CI, 2.3-4.8), followed by the group undergoing high-intensity interval training with a significant pooled improvement in VO 2 peak 3.5 (95% CI, 2.6-4.4) and combined aerobic and resistance exercise with an SMD of 3.2 (95% CI, 1.4-5.0). The inspiratory muscle training, high-intensity interval training, and combined aerobic and resistance exercise were the highest ranked physical rehabilitation intervention to improve VO 2 peak. These interventions should be considered as a component in the care of patients with HFpEF. Registration: https://www.crd.york.ac.uk/PROSPERO/ ; Unique identifier: CRD42021256442.
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Gomes-Neto et al. (2022) conducted a meta-analysis in Heart failure with preserved ejection fraction (HFpEF) (n=720). Exercise interventions (inspiratory muscle training, high-intensity interval training, combined aerobic and resistance exercise) vs. Usual care was evaluated on Aerobic capacity measured by peak oxygen consumption (VO2 peak) (SMD 3.6, 95% CI 2.3-4.8). Inspiratory muscle training was the highest ranked exercise intervention for improving VO2 peak in HFpEF patients (SMD 3.6; 95% CI 2.3-4.8), followed by high-intensity interval training.
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