Effects of Exercise on LV Remodeling in Heart Failure
Effects of Exercise on LV Remodeling in Heart Failure
After screening titles and abstracts of all studies identified by the screening strategy, 47 potentially relevant articles were selected and retrieved for more detailed information. Further screening for eligibility was performed by two independent reviewers using the inclusion and exclusion criteria (Figure 1). Ultimately, eight new RCTs met the inclusion criteria and were included in our systematic review. Together with seven trials that had been included in Haykowsky et al.'s meta-analysis, a total of 15 trials were included into this study.
(Enlarge Image)
Figure 1.
Selection process for studies included in meta-analysis
Among them, the work of Mandic et al. was separated into two different comparisons (aerobic training alone or combined strength training). Thus, there were a total of 16 comparisons to evaluate the effect of exercise training on left ventricular remodelling.
Table 1 shows the characteristics of the included trials. All trials included a total of 813 patients (425 patients in the exercise group and 338 patients in the control group). The heart failure patients were relatively young (mean age ranged from 54 to 75 years) and predominantly male. Most trails incorporated aerobic training at intensity between 60% and 80% of baseline VO2peak. Twelve trials examined the effects of aerobic training; six of these trials duration were more than 6 months. Three trials examined the effects of combined aerobic and strength training, and one trial examined strength training alone.
A number of studies failed to give sufficient details to assess their potential risk of bias. Details of generation and concealment of random allocation sequence were particularly poorly reported. Therefore, trials scored relatively poorly on the Jadads scale: two received a score of 1 of 5, nine studies received a score of 2 of 5 and four studies scored of 3 of 5.
Pooled outcome findings are summarised in Table 2.
Results
Identification and Selection of Studies
After screening titles and abstracts of all studies identified by the screening strategy, 47 potentially relevant articles were selected and retrieved for more detailed information. Further screening for eligibility was performed by two independent reviewers using the inclusion and exclusion criteria (Figure 1). Ultimately, eight new RCTs met the inclusion criteria and were included in our systematic review. Together with seven trials that had been included in Haykowsky et al.'s meta-analysis, a total of 15 trials were included into this study.
(Enlarge Image)
Figure 1.
Selection process for studies included in meta-analysis
Among them, the work of Mandic et al. was separated into two different comparisons (aerobic training alone or combined strength training). Thus, there were a total of 16 comparisons to evaluate the effect of exercise training on left ventricular remodelling.
Trials Included
Table 1 shows the characteristics of the included trials. All trials included a total of 813 patients (425 patients in the exercise group and 338 patients in the control group). The heart failure patients were relatively young (mean age ranged from 54 to 75 years) and predominantly male. Most trails incorporated aerobic training at intensity between 60% and 80% of baseline VO2peak. Twelve trials examined the effects of aerobic training; six of these trials duration were more than 6 months. Three trials examined the effects of combined aerobic and strength training, and one trial examined strength training alone.
A number of studies failed to give sufficient details to assess their potential risk of bias. Details of generation and concealment of random allocation sequence were particularly poorly reported. Therefore, trials scored relatively poorly on the Jadads scale: two received a score of 1 of 5, nine studies received a score of 2 of 5 and four studies scored of 3 of 5.
Outcomes
Pooled outcome findings are summarised in Table 2.
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