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Exercise training for systolic heart failure : Cochrane systematic review and meta-analysis
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Davies, Edward J., Moxham, Tiffany, Rees, Karen, Singh, Sally, Coats, Andrew J.S., Ebrahim, Shah, Lough, Fiona and Taylor, Rod S. (2010) Exercise training for systolic heart failure : Cochrane systematic review and meta-analysis. European Journal of Heart Failure, 12 (7). pp. 706-715. doi:10.1093/eurjhf/hfq056 ISSN 1388-9842.
An open access version can be found in:
Official URL: http://dx.doi.org/10.1093/eurjhf/hfq056
Abstract
Aims
To determine the effect of exercise training on clinical events and health-related quality of life (HRQoL) of patients with systolic heart failure.
Methods and results
We searched electronic databases including Medline, EMBASE, and Cochrane Library up to January 2008 to identify randomized controlled trials (RCTs) comparing exercise training and usual care with a minimum follow-up of 6 months. Nineteen RCTs were included with a total of 3647 patients, the majority of whom were male, low-to-medium risk, and New York Heart Association class II–III with a left ventricular ejection fraction of <40%. There was no significant difference between exercise and control in short-term (≤12 months) or longer-term all-cause mortality or overall hospital admissions. Heart failure-related hospitalizations were lower [relative risk: 0.72, 95% confidence interval (CI): 0.52–0.99] and HRQoL improved (standardized mean difference: −0.63, 95% CI: −0.80 to −0.37) with exercise therapy. Any effect of cardiac exercise training on total mortality and HRQoL was independent of degree of left ventricular dysfunction, type of cardiac rehabilitation, dose of exercise intervention, length of follow-up, trial quality, and trial publication date.
Conclusion
Compared with usual care, in selected heart failure patients, exercise training reduces heart failure-related hospitalizations and results in clinically important improvements in HRQoL. High-quality RCT and cost-effectiveness evidence is needed for the effect of exercise training in community-based settings and in more severe heart failure patients, elderly people, and women.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | European Journal of Heart Failure | ||||
ISSN: | 1388-9842 | ||||
Official Date: | July 2010 | ||||
Dates: |
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Volume: | 12 | ||||
Number: | 7 | ||||
Page Range: | pp. 706-715 | ||||
DOI: | 10.1093/eurjhf/hfq056 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Open Access (Creative Commons) | ||||
Open Access Version: |
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