Exercise training in patients with heart disease: review of beneficial effects and clinical recommendations.
Study Goal
The researchers aimed to review the prognostic and symptomatic benefits of exercise training, including High-Intensity Interval Training (HIIT), in various cardiovascular diseases.
Results Summary
The study found that HIIT may achieve superior improvements in aerobic exercise capacity and muscle mass, though its prognostic value still needs further determination. It also highlighted benefits in conditions like heart failure with preserved ejection fraction and pulmonary hypertension.
Population
Patients with cardiovascular diseases, including stable coronary artery disease, heart failure (reduced and preserved ejection fraction), pulmonary hypertension, and valvular heart disease.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
exercise training | decrease | stable coronary artery disease (CAD) | patients with stable coronary artery disease (CAD) | - | attenuates disease progression | #1 |
exercise training | decrease | CVD risk factors (i.e., hyperlipidemia, hypertension) | patients with stable coronary artery disease (CAD) | - | beneficially influences | #2 |
exercise training | increase | coronary endothelial function | patients with stable coronary artery disease (CAD) | - | beneficially influences | #3 |
exercise training | increase | exercise capacity | patients with heart failure (HF) with reduced ejection fraction (HFrEF) | - | prevents the progressive loss | #4 |
exercise training | decrease | peripheral skeletal muscle wasting | patients with heart failure (HF) with reduced ejection fraction (HFrEF) | - | antagonizing | #5 |
exercise training | increase | left ventricular reverse remodeling | patients with heart failure (HF) with reduced ejection fraction (HFrEF) | - | promoting | #6 |
exercise training | decrease | cardiomegaly | patients with heart failure (HF) with reduced ejection fraction (HFrEF) | - | reduction in | #7 |
exercise training | increase | ejection fraction | patients with heart failure (HF) with reduced ejection fraction (HFrEF) | - | improvement of | #8 |
exercise training | increase | left ventricular diastolic function | patients with HF with preserved ejection fraction (HFpEF) | - | lusitropic effect | #9 |
exercise training | increase | exercise capacity | patients with HF with preserved ejection fraction (HFpEF) | - | symptomatic improvement | #10 |
endurance exercise training | decrease | pulmonary artery pressure | patients with pulmonary hypertension | - | reductions in | #11 |
high-intensity interval training, resistance training and others | increase | aerobic exercise capacity | - | - | may achieve superior improvements | #12 |
high-intensity interval training, resistance training and others | increase | muscle mass | - | - | gain in | #13 |
Over the last decades exercise training has evolved into an established evidence-based therapeutic strategy with prognostic benefits in many cardiovascular diseases (CVDs): In stable coronary artery disease (CAD) exercise training attenuates disease progression by beneficially influencing CVD risk factors (i.e., hyperlipidemia, hypertension) and coronary endothelial function. In heart failure (HF) with reduced ejection fraction (HFrEF) training prevents the progressive loss of exercise capacity by antagonizing peripheral skeletal muscle wasting and by promoting left ventricular reverse remodeling with reduction in cardiomegaly and improvement of ejection fraction. Novel areas for exercise training interventions include HF with preserved ejection fraction (HFpEF), pulmonary hypertension, and valvular heart disease. In HFpEF, randomized studies indicate a lusitropic effect of training on left ventricular diastolic function associated with symptomatic improvement of exercise capacity. In pulmonary hypertension, reductions in pulmonary artery pressure were observed following endurance exercise training. Recently, innovative training methods such as high-intensity interval training, resistance training and others have been introduced. Although their prognostic value still needs to be determined, these approaches may achieve superior improvements in aerobic exercise capacity and gain in muscle mass, respectively. In this review, we give an overview of the prognostic and symptomatic benefits of exercise training in the most common cardiac disease entities. Additionally, key guideline recommendations for the initiation of training programs are summarized.