A meta-analysis of the effect of exercise training on left ventricular remodeling in heart failure patients - The benefit depends on the type of training performed
A meta-analysis of the effect of exercise training on left ventricular remodeling in heart failure patients - The benefit depends on the type of training performed
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DOI：
10.1016/j.jacc.2007.02.055
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发表时间：
2007-06-19
影响因子：
24
通讯作者：
Clark, Alexander M.
中科院分区：
文献类型：
--
作者：
Haykowsky, Mark J.;Liang, Yuanyuan;Clark, Alexander M.
目的本研究的目的是确定运动训练和运动类型（有氧、力量、联合训练）对心力衰竭（HF）患者左心室（LV）重构的影响。大量的随机对照试验研究了运动训练对心衰患者左室重构的影响。然而，这些试验的结果尚无定论。方法：作者检索了MEDLINE（1966 - 2006）、Cochrane中央对照试验登记册（2006年第3期）、CINAHL（1982 - 2006年）、EMBASE（1988 - 2006年）、PubMed（1966 - 2006年）和随机对照试验的参考文献列表，这些随机对照试验检查了运动训练对临床稳定的HE患者射血分数（EF）、舒张末期容积（EDV）和收缩末期容积（ESV）的影响，如果合适的话，还联系了主要研究作者。研究选择和数据提取由2名审稿人独立进行。加权平均差（WMD）采用随机效应模型计算。结果14项试验报告了EF数据（n = 812例）。7项试验同时报告了EDV和ESV数据（n = 569）。有氧训练显著改善EF（9项试验，538例患者，WMD = 2.59%； 95%可信区间[Cl] 1.44%至3.74%）、EDV（371例患者，WMD = -11.49 ml; 95% Cl -19.95至-3.02 ml）和ESV（371例患者，WMD = -12.87 ml; 95% Cl -17.80至-7.93 ml）。有氧和力量联合训练与EF、EDV或ESV的显著改善无关。结论：有氧训练可逆转临床稳定的HE患者左室重构，但有氧和力量训练联合使用的效果尚未得到证实。
ObjectivesThe aim of this study was to determine the effect of exercise training and type of exercise (aerobic vs. strength vs. combined training) on left ventricular (LV) remodeling in heart failure (HF).BackgroundA number of randomized controlled trials have examined the effect of exercise training on LV remodeling in individuals with HF. However, the results of these trials have been inconclusive.MethodsThe authors searched MEDLINE (1966 to 2006), Cochrane Central Register of Controlled Trials (issue #3, 2006), CINAHL (1982 to 2006), EMBASE (1988 to 2006), PubMed (1966 to 2006), and reference lists of identified studies for randomized controlled trials examining the effects of exercise training on ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volume (ESV) in clinically stable patients with HE Primary study authors were also contacted if appropriate. Studies were selected and data were extracted independently by 2 reviewers. Weighted mean differences (WMD) were calculated using a random effects model.ResultsFourteen trials reported EF data (n = 812 patients). Seven trials reported both EDV and ESV data (n = 569). Aerobic training significantly improved EF (9 trials, 538 patients, WMD = 2.59%; 95% confidence interval [Cl] 1.44% to 3.74%), EDV (371 patients; WMD = -11.49 ml; 95% Cl -19.95 to -3.02 ml) and ESV (371 patients; WMD = -12.87 ml; 95% Cl -17.80 to -7.93 ml). Combined aerobic and strength training was not associated with significant improvements in EF, EDV, or ESV.ConclusionsAerobic training reverses LV remodeling in clinically stable individuals with HE This benefit was not confirmed with combined aerobic and strength training.