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Effects of drug and exercise intervention on functional capacity and quality of life in heart failure with preserved ejection fraction: A meta-analysis of randomized controlled trials.
Eur J Prev Cardiol 2016; 23(1):78-85EJ

Abstract

BACKGROUND

Patients with heart failure with preserved ejection fraction (HFpEF) are often elderly and their primary chronic symptom is severe exercise intolerance that results in a reduced quality of life (QOL).Thus, improvement of exercise capacity and QOL presents an important clinical outcome in HFpEF patients. Although the effects of interventions such as cardiovascular drugs and exercise training on exercise capacity and QOL in HFpEF patients have been examined in a number of clinical trials, the results are inconsistent due in part to limited power with small sample sizes. We aimed to conduct a meta-analysis of the randomized controlled trial (RCT)s on the effect of drug or exercise intervention on exercise capacity and QOL in HFpEF patients.

METHOD AND RESULTS

The search of electronic databases identified five RCTs on exercise (245 patients) and eight RCTs on cardiovascular drugs (1080 patients). The pooled analysis showed that exercise training improved peak exercise oxygen uptake (VO2) (weighted mean difference (WMD) 2.283, 95% confidence interval (CI)) (1.318-3.248) ml/min/kg), six-minute walk distance (6MWD) (30.275 m (4.315-56.234)), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) total score (8.974 points (3.321-14.627)) compared with usual care. In contrast, drug intervention did not improve peak VO2 (WMD (95% CI), -0.393 (-1.005-0.220) ml/min/kg), 6MWD (-9.463 (-21.455-2.530) m), or MLHFQ total score (1.042 (-0.982-3.066) point) compared with placebo or no treatment.

CONCLUSION

Our meta-analysis indicates that exercise training may be a therapeutic option to improve functional capacity and QOL in HFpEF patients.

Authors+Show Affiliations

Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Japan fukuta-h@med.nagoya-cu.ac.jp.Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Japan.Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Japan.Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Japan.

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

25520380

Citation

Fukuta, Hidekatsu, et al. "Effects of Drug and Exercise Intervention On Functional Capacity and Quality of Life in Heart Failure With Preserved Ejection Fraction: a Meta-analysis of Randomized Controlled Trials." European Journal of Preventive Cardiology, vol. 23, no. 1, 2016, pp. 78-85.
Fukuta H, Goto T, Wakami K, et al. Effects of drug and exercise intervention on functional capacity and quality of life in heart failure with preserved ejection fraction: A meta-analysis of randomized controlled trials. Eur J Prev Cardiol. 2016;23(1):78-85.
Fukuta, H., Goto, T., Wakami, K., & Ohte, N. (2016). Effects of drug and exercise intervention on functional capacity and quality of life in heart failure with preserved ejection fraction: A meta-analysis of randomized controlled trials. European Journal of Preventive Cardiology, 23(1), pp. 78-85. doi:10.1177/2047487314564729.
Fukuta H, et al. Effects of Drug and Exercise Intervention On Functional Capacity and Quality of Life in Heart Failure With Preserved Ejection Fraction: a Meta-analysis of Randomized Controlled Trials. Eur J Prev Cardiol. 2016;23(1):78-85. PubMed PMID: 25520380.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of drug and exercise intervention on functional capacity and quality of life in heart failure with preserved ejection fraction: A meta-analysis of randomized controlled trials. AU - Fukuta,Hidekatsu, AU - Goto,Toshihiko, AU - Wakami,Kazuaki, AU - Ohte,Nobuyuki, Y1 - 2014/12/17/ PY - 2014/10/02/received PY - 2014/11/28/accepted PY - 2014/12/19/entrez PY - 2014/12/19/pubmed PY - 2016/9/20/medline KW - Heart failure with preserved ejection fraction KW - exercise training KW - meta-analysis KW - pharmacotherapy KW - quality of life KW - randomized controlled trial SP - 78 EP - 85 JF - European journal of preventive cardiology JO - Eur J Prev Cardiol VL - 23 IS - 1 N2 - BACKGROUND: Patients with heart failure with preserved ejection fraction (HFpEF) are often elderly and their primary chronic symptom is severe exercise intolerance that results in a reduced quality of life (QOL).Thus, improvement of exercise capacity and QOL presents an important clinical outcome in HFpEF patients. Although the effects of interventions such as cardiovascular drugs and exercise training on exercise capacity and QOL in HFpEF patients have been examined in a number of clinical trials, the results are inconsistent due in part to limited power with small sample sizes. We aimed to conduct a meta-analysis of the randomized controlled trial (RCT)s on the effect of drug or exercise intervention on exercise capacity and QOL in HFpEF patients. METHOD AND RESULTS: The search of electronic databases identified five RCTs on exercise (245 patients) and eight RCTs on cardiovascular drugs (1080 patients). The pooled analysis showed that exercise training improved peak exercise oxygen uptake (VO2) (weighted mean difference (WMD) 2.283, 95% confidence interval (CI)) (1.318-3.248) ml/min/kg), six-minute walk distance (6MWD) (30.275 m (4.315-56.234)), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) total score (8.974 points (3.321-14.627)) compared with usual care. In contrast, drug intervention did not improve peak VO2 (WMD (95% CI), -0.393 (-1.005-0.220) ml/min/kg), 6MWD (-9.463 (-21.455-2.530) m), or MLHFQ total score (1.042 (-0.982-3.066) point) compared with placebo or no treatment. CONCLUSION: Our meta-analysis indicates that exercise training may be a therapeutic option to improve functional capacity and QOL in HFpEF patients. SN - 2047-4881 UR - https://www.unboundmedicine.com/medline/citation/25520380/Effects_of_drug_and_exercise_intervention_on_functional_capacity_and_quality_of_life_in_heart_failure_with_preserved_ejection_fraction:_A_meta_analysis_of_randomized_controlled_trials_ L2 - http://journals.sagepub.com/doi/full/10.1177/2047487314564729?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -