METHODS: We systematically reviewed the literature, searching from inception to December 2023, utilizing databases such as MEDLINE (via PubMed), Google Scholar, the Cochrane Library, ClinicalTrials.gov, and the ScienceDirect portal. Statistical analyses utilized RevMan 5.4 with a random-effects model. Outcomes were presented as the weighted mean difference (WMD) alongside corresponding 95 % confidence intervals (CI), and heterogeneity was assessed using the I2 test.
RESULTS: Our final analysis included 7 randomized controlled trials (RCTs) of 346 participants, with an exercise follow-up duration of 12 to 48 weeks. In our pooled analysis, diastolic function, measured by E/A (WMD 0.01, 95 % CI: -0.04 to 0.05, p = 0.79; I2 = 0 %) and E/e\' (WMD 0.87, 95 % CI: -11.09 to 12.83, p = 0.89; I2 = 69 %), showed no significant change post-exercise training. However, exercise capacity, measured by peak V̇o2 significantly improved (WMD 2.57, 95 % CI: 1.38 to 3.75, p < 0.0001; I2= 14 %). The QoL assessed by the Minnesota Living with Heart Failure (MLWHF) score remained unchanged (WMD -3.12, 95 % CI: -8.73 to 2.50, p = 0.28; I2 = 0 %), but the SF-36 physical functioning scale indicated significant improvement (WMD 9.84, 95 % CI: 2.94 to 16.73, p < 0.005; I2 = 0 %). Arterial stiffness and vascular function remained unaffected, as evidenced by arterial elastance (WMD -0.13, 95 % CI: -0.36 to 0.10, p = 0.26; I2 = 0 %) and total arterial compliance (WMD 0.12, 95 % CI: -0.26 to 0.49, p = 0.54; I2 = 0 %).
CONCLUSIONS: Exercise training is safe and significantly enhances exercise capacity and QoL in HFpEF, with no significant impact on diastolic function, arterial stiffness, or vascular function.
方法:我们系统回顾了文献,从开始到2023年12月的搜索,利用MEDLINE(通过PubMed)等数据库,谷歌学者,Cochrane图书馆,ClinicalTrials.gov,和ScienceDirect门户。统计分析使用RevMan5.4和随机效应模型。结果以加权平均差(WMD)和相应的95%置信区间(CI)表示,使用I2检验评估异质性。
结果:我们的最终分析包括346名参与者的7项随机对照试验(RCT),运动随访时间为12至48周。在我们的汇总分析中,舒张功能,通过E/A(WMD0.01,95%CI:-0.04至0.05,p=0.79;I2=0%)和E/e'(WMD0.87,95%CI:-11.09至12.83,p=0.89;I2=69%),运动训练后无明显变化。然而,锻炼能力,通过峰值测量V
结论:运动训练是安全的,并且可以显着提高HFpEF的运动能力和QoL,对舒张功能没有显著影响,动脉僵硬度,或血管功能。