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
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
复制标题
DOI：
10.1177/2047487314564729
复制
发表时间：
2016-01-01
影响因子：
8.3
通讯作者：
Ohte, Nobuyuki
中科院分区：
文献类型：
--
作者：
Fukuta, Hidekatsu;Goto, Toshihiko;Ohte, Nobuyuki
研究背景射血分数保留性心力衰竭（HFpEF）患者多为老年人，其主要慢性症状为严重的运动不耐受，导致生活质量（QOL）下降，因此改善HFpEF患者的运动能力和QOL是其重要的临床结局。虽然在一些临床试验中已经检查了干预措施（如心血管药物和运动训练）对HFpEF患者运动能力和QOL的影响，但结果不一致，部分原因是样本量小，效力有限。我们的目的是进行一项荟萃分析的随机对照试验（RCT）的药物或运动干预的影响运动能力和生活质量在HFpEF patients.Method和结果的电子数据库的搜索确定了5个RCT运动（245例）和8个RCT心血管药物（1080例）。汇总分析显示，运动训练改善了运动峰值摄氧量（VO 2）（加权平均差（WMD）2.283，95%置信区间（CI））（1.318-3.248）ml/min/kg），6分钟步行距离（6 MWD）（30.275 m（4.315-56.234））和明尼苏达心力衰竭生活问卷（MLHFQ）总分（8.974分（3.321-14.627））与常规护理相比。相比之下，药物干预并没有改善峰值VO 2（WMD（95% CI），-0.393（-1.005-0.220）ml/min/kg），6MWD（-9.463（-21.455-2.530）m），或MLHFQ总分（1.042（-0.982-3.066）分）。分析表明，运动训练可能是一种治疗选择，以改善HFpEF患者的功能能力和生活质量。
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) (30.275m (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.