Exercise-based cardiac rehabilitation for patients following open surgical aortic valve replacement and transcatheter aortic valve implant: A systematic review and meta-analysis
dc.contributor.author | Anayo, L | |
dc.contributor.author | Rogers, P | |
dc.contributor.author | Long, L | |
dc.contributor.author | Dalby, M | |
dc.contributor.author | Taylor, R | |
dc.date.accessioned | 2019-10-29T13:08:31Z | |
dc.date.issued | 2019-04-09 | |
dc.description.abstract | Objectives: Exercise-based cardiac rehabilitation (CR) may be beneficial to patients following transcatheter aortic valve implantation (TAVI) and open surgical aortic valve replacement (SAVR). We aimed to undertake a systematic review and meta-analysis to evaluate the efficacy, safety and costs of exercise-based CR post-TAVI and post-SAVR. Methods: We searched numerous databases, including Embase, CENTRAL and MEDLINE, up to October 2017. We included randomised controlled trials (RCTs) and non-randomised controlled trials (non-RCTs) of exercise-based CR compared with no exercise control in TAVI or SAVR patients ≥18 years. Data extraction and risk of bias assessments were performed independently by two reviewers. Narrative synthesis and meta-analysis (where appropriate) were carried out for all relevant outcomes, and a Grading of Recommendations Assessment, Development and Evaluation (GRADE) analysis was also performed. Results Six studies, all at low risk of bias, were included: three RCTs and three non-RCTs (total of 27 TAVI, 99 SAVR and 129 mixed patients), with follow-up of 2-12 months. There was an increase in pooled exercise capacity (standardised mean difference: 0.41, 95% CI 0.11 to 0.70; moderate certainty evidence as assessed by GRADE), with exercise-based rehabilitation compared with control. Data on other outcomes including quality of life and clinical events were limited. Conclusions: Exercise-based CR probably improves exercise capacity of post-TAVI and post-SAVR patients in the short term. Well conducted multicentre fully powered RCTs of ≥12 months follow-up are needed to fully assess the clinical and cost-effectiveness of exercise-based CR in this patient population. PROSPERO Protocol Registration Number CRD42017084716. | en_GB |
dc.identifier.citation | Vol. 6, 000922 | en_GB |
dc.identifier.doi | 10.1136/openhrt-2018-000922 | |
dc.identifier.uri | http://hdl.handle.net/10871/39375 | |
dc.language.iso | en | en_GB |
dc.publisher | BMJ Publishing | en_GB |
dc.rights | This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ | en_GB |
dc.title | Exercise-based cardiac rehabilitation for patients following open surgical aortic valve replacement and transcatheter aortic valve implant: A systematic review and meta-analysis | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2019-10-29T13:08:31Z | |
dc.identifier.issn | 2398-595X | |
dc.description | This is the final version. Available from BMJ Publishing via the DOI in this record. | en_GB |
dc.identifier.journal | Open Heart | en_GB |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ | en_GB |
dcterms.dateAccepted | 2019-02-16 | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2019-04-09 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2019-10-29T13:04:50Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2019-10-29T13:08:35Z | |
refterms.panel | A | en_GB |
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