Exercise-based cardiac rehabilitation for adults with heart failure - 2023 Cochrane systematic review and meta-analysis
dc.contributor.author | Molloy, CD | |
dc.contributor.author | Long, L | |
dc.contributor.author | Mordi, IR | |
dc.contributor.author | Bridges, C | |
dc.contributor.author | Sagar, VA | |
dc.contributor.author | Davies, EJ | |
dc.contributor.author | Coats, AJS | |
dc.contributor.author | Dalal, H | |
dc.contributor.author | Rees, K | |
dc.contributor.author | Singh, SJ | |
dc.contributor.author | Taylor, RS | |
dc.date.accessioned | 2023-11-28T09:29:24Z | |
dc.date.issued | 2023-10-18 | |
dc.date.updated | 2023-11-28T09:14:00Z | |
dc.description.abstract | AIMS: Despite strong evidence, access to exercise-based cardiac rehabilitation (ExCR) remains low across global healthcare systems. We provide a contemporary update of the Cochrane review randomized trial evidence for ExCR for adults with heart failure (HF) and compare different delivery modes: centre-based, home-based (including digital support), and both (hybrid). METHODS AND RESULTS: Databases, bibliographies of previous systematic reviews and included trials, and trials registers were searched with no language restrictions. Randomized controlled trials, recruiting adults with HF, assigned to either ExCR or a no-exercise control group, with follow-up of ≥6 months were included. Two review authors independently screened titles for inclusion, extracted trial and patient characteristics, outcome data, and assessed risk of bias. Outcomes of mortality, hospitalization, and health-related quality of life (HRQoL) were pooled across trials using meta-analysis at short-term (≤12 months) and long-term follow-up (>12 months) and stratified by delivery mode. Sixty trials (8728 participants) were included. In the short term, compared to control, ExCR did not impact all-cause mortality (relative risk [RR] 0.93; 95% confidence interval [CI] 0.71-1.21), reduced all-cause hospitalization (RR 0.69; 95% CI 0.56-0.86, number needed to treat: 13, 95% CI 9-22), and was associated with a clinically important improvement in HRQoL measured by the Minnesota Living with Heart Failure Questionnaire (MLWHF) overall score (mean difference: -7.39; 95% CI -10.30 to -4.47). Improvements in outcomes with ExCR was seen across centre, home (including digitally supported), and hybrid settings. A similar pattern of results was seen in the long term (mortality: RR 0.87, 95% CI 0.72-1.04; all-cause hospitalization: RR 0.84, 95% CI 0.70-1.01, MLWHF: -9.59, 95% CI -17.48 to -1.50). CONCLUSIONS: To improve global suboptimal levels of uptake for HF patients, global healthcare systems need to routinely recommend ExCR and offer a choice of mode of delivery, dependent on an individual patient's level of risk and complexity. | en_GB |
dc.format.medium | Print-Electronic | |
dc.identifier.citation | Published online 18 October 2023 | en_GB |
dc.identifier.doi | https://doi.org/10.1002/ejhf.3046 | |
dc.identifier.uri | http://hdl.handle.net/10871/134678 | |
dc.identifier | ORCID: 0000-0002-7316-7544 (Dalal, Hasnain) | |
dc.language.iso | en | en_GB |
dc.publisher | Wiley / European Society of Cardiology | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/37850321 | en_GB |
dc.rights | © 2023 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made | en_GB |
dc.subject | Cardiac rehabilitation | en_GB |
dc.subject | Exercise training | en_GB |
dc.subject | Health-related quality of life | en_GB |
dc.subject | Heart failure | en_GB |
dc.subject | Hospitalization | en_GB |
dc.subject | Mortality | en_GB |
dc.title | Exercise-based cardiac rehabilitation for adults with heart failure - 2023 Cochrane systematic review and meta-analysis | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2023-11-28T09:29:24Z | |
dc.identifier.issn | 1388-9842 | |
exeter.place-of-publication | England | |
dc.description | This is the final version. Available on open access from Wiley via the DOI in this record | en_GB |
dc.identifier.eissn | 1879-0844 | |
dc.identifier.journal | European Journal of Heart Failure | en_GB |
dc.relation.ispartof | Eur J Heart Fail | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/ | en_GB |
dcterms.dateAccepted | 2023-10-02 | |
dc.rights.license | CC BY-NC-ND | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2023-10-18 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2023-11-28T09:24:52Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2023-11-28T09:29:40Z | |
refterms.panel | A | en_GB |
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Except where otherwise noted, this item's licence is described as © 2023 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and
distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made