Effects of exercise based cardiac rehabilitation delivery modes on chronic heart failure: a systematic review and network meta-analysis.
Study Goal
The researchers aimed to compare the effectiveness of different cardiac rehabilitation interventions, including High-Intensity Interval Training (HIIT), in improving outcomes for chronic heart failure patients.
Results Summary
Center-based cardiac rehabilitation with HIIT was the most effective in enhancing left ventricular ejection fraction (LVEF). Combined CR with aerobic and resistance training improved quality of life, exercise capacity, and reduced rehospitalization rates.
Population
Chronic heart failure (CHF) patients
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
All interventions | increase | routine care | - | - | outperformed | #1 |
Combined CR with aerobic exercise and resistance training (HCR [AE + RE]) | increase | Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores | - | - | significantly improved | #2 |
Combined CR with aerobic exercise and resistance training (HCR [AE + RE]) | increase | 6-min walk test (6MWT) performance | - | - | significantly improved | #3 |
Combined CR with aerobic exercise and resistance training (HCR [AE + RE]) | decrease | rehospitalization rates | - | - | reduced | #4 |
Center-based cardiac rehabilitation (CBCR) with high-intensity interval training (HIIT) | increase | left ventricular ejection fraction (LVEF) | - | - | was the most effective in enhancing | #5 |
CBCR(AE) | increase | peak oxygen uptake (Peak VO2) | - | - | demonstrated the greatest improvement in | #6 |
Chronic heart failure (CHF) represents one of the most severe and advanced stages of cardiovascular disease. Despite the critical importance of cardiac rehabilitation (CR) in CHF management, while studies have explored the effectiveness of various CR delivery modes and offered valuable context-specific insights, their relative efficacy remains inconsistent across different patient groups, healthcare environments, and intervention approaches. A clearer understanding requires comprehensive comparisons and in-depth analyses to address these variations. Systematic searches were conducted in databases including Pubmed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science, up to August 2024. Two researchers independently screened the literature according to strict inclusion criteria, extracted relevant data, and assessed the quality of included studies using Cochrane Collaboration tools and the Jadad scale. Subsequent pairwise and network meta-analyses were performed using statistical software, including Stata 17.0, to present the results graphically. The network meta-analysis included 9,552 articles, with 33 meeting the inclusion criteria and examining eleven different interventions. All interventions outperformed routine care. Combined CR with aerobic exercise and resistance training (HCR [AE + RE]) significantly improved Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores and 6-min walk test (6MWT) performance, and reduced rehospitalization rates [SUCRA = 96%]. Center-based cardiac rehabilitation (CBCR) with high-intensity interval training (HIIT) was the most effective in enhancing left ventricular ejection fraction (LVEF), while CBCR(AE) demonstrated the greatest improvement in peak oxygen uptake (Peak VO