Heart failure & cardiomyopathies
Dose-Response Associations of Exercise Modalities With Cardiorespiratory Fitness in Heart Failure: A Systematic Review and Bayesian Network Meta-Analysis
Authors' conclusion
The exercise dose-response relationship in heart failure follows an Emax curve, with distinct dose-benefit profiles across different exercise modalities. Based on the current evidence, the following preliminary considerations may be offered: for patients with limited exercise tolerance, MBT may be considered as one of the preferred options; for those with moderate exercise tolerance, IAT+RT or CAT+RT may be suitable choices; for patients with good exercise tolerance, IAT or RT may be considered; and for patients with comorbid obesity, CAT may be incorporated into a comprehensive management program.
Study context
- Population
- Patients with heart failure in randomized controlled trials comparing exercise interventions with controlspatients in 100 trials
- Participants
- 5,353 patients
- Comparison
- Exercise interventions compared with controls; effects of exercise modalities and standardized doses (MET-min/week) on VO2peak
- Outcome
- Dose-response relationship for VO2peak
Methodological detailsBayesian model-based network dose-response meta-analysis, randomized controlled trials
- Bayesian model-based network dose-response meta-analysis
- Randomized controlled trials
Pooled result
As reported in the abstract
ED50 values
80-90 MET-min/week
Weekly dose of 500 MET-min yielded considerable benefit
500 MET-min
Dose approaching maximal benefit for nearly all modalities
750-1000 MET-min
Further pooled results
Emax
| Outcome | IAT | RT | IAT+RT |
|---|---|---|---|
| Top three ranked interventions (Emax, VO2peak) | 3.50 (95% CrI 2.49–4.60) | 3.66 (95% CrI 1.96–5.85) | 3.49 (95% CrI 1.26–5.79) |
Original publication
Summarised from the published abstract; every number is checked against it