PMID- 35773043
OWN - NLM
STAT- MEDLINE
DCOM- 20220816
LR  - 20221121
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 178
DP  - 2022 Sep 1
TI  - Meta-analysis Analyzing the Effect of Therapies on 6-Minute Walk Distance in 
      Heart Failure With Reduced Ejection Fraction.
PG  - 72-79
LID - S0002-9149(22)00585-9 [pii]
LID - 10.1016/j.amjcard.2022.05.023 [doi]
AB  - The 6-minute walk distance (6MWD) carries prognostic value in patients with heart 
      failure with reduced ejection fraction (HFrEF). We performed this systematic 
      review and meta-analysis to evaluate the effect of heart failure therapies on 
      improvement in 6MWD. A systematic search of MEDLINE and Embase was conducted for 
      randomized controlled trials measuring 6MWD at baseline and at follow-up in at 
      least 50 patients with HFrEF across both arms. The primary outcome was 
      improvement in 6MWD at follow-up. Meta-analysis was stratified in groups on the 
      basis of medical therapy, device-based therapy, autonomic modulation, and 
      exercise. Mean differences (MDs) with 95% confidence interval (CI) were reported 
      across multiple studies that were included in the meta-analysis. A total of 44 
      studies met the inclusion criteria for systematic review; 17 of which were 
      included for meta-analysis. Statistical analysis showed a statistically 
      significant improvement in 6MWD in meters (m) at follow-up for device-based 
      therapy (MD 20.01 m, 95% CI 18.71 to 21.31), autonomic modulation (MD 76.64 m, 
      95% CI 54.10 to 99.19), and exercise group (MD 39.52 m, 95% CI 19.68 to 59.35). 
      Pooled analysis of medical therapy did not show statistically significant 
      improvement in 6MWD at follow-up (MD 31.69 m, 95% CI -6.52 to 69.91). 
      Device-based therapy (cardiac resynchronization therapy and cardiac contractility 
      modulation), autonomic modulation, and exercise training programs are associated 
      with improvement in 6MWD in patients with HFrEF. 6MWD is a useful test to gauge 
      improvement in functional capacity among patients with HFrEF, especially those 
      with severe symptomatic heart failure.
CI  - Copyright (c) 2022 Elsevier Inc. All rights reserved.
FAU - Akhtar, Khawaja H
AU  - Akhtar KH
AD  - Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma 
      City, Oklahoma.
FAU - Johnston, Sarah
AU  - Johnston S
AD  - Department of Biostatistics and Epidemiology, Hudson College of Public Health, 
      University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
FAU - Zhao, Yan Daniel
AU  - Zhao YD
AD  - Department of Biostatistics and Epidemiology, Hudson College of Public Health, 
      University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
FAU - Amil, Faris
AU  - Amil F
AD  - Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma 
      City, Oklahoma.
FAU - Ford, Lance
AU  - Ford L
AD  - Department of Biostatistics and Epidemiology, Hudson College of Public Health, 
      University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
FAU - Lindenfeld, JoAnn
AU  - Lindenfeld J
AD  - Cardiovascular Section, Department of Medicine, Vanderbilt University Medical 
      Center, Nashville, Tennessee.
FAU - Dasari, Tarun W
AU  - Dasari TW
AD  - Cardiovascular Section, Department of Medicine, Heart Rhythm Institute, 
      University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. 
      Electronic address: Tarun-Dasari@ouhsc.edu.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220628
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Exercise Therapy
MH  - Exercise Tolerance
MH  - *Heart Failure/therapy
MH  - Humans
MH  - Quality of Life
MH  - Stroke Volume
COIS- Disclosures JoAnn Lindenfeld reports a relationship with Volumetrix and Sensible 
      Medical that includes funding grants; a relationship with Novartis, Boehringer 
      Ingelheim, CVRx, Impulse Dynamics, Vwave, Edwards Lifesciences, and Abbott that 
      includes: consulting or advisory; and a relationship Astra Zeneca that includes 
      funding grants and consulting or advisory.
EDAT- 2022/07/01 06:00
MHDA- 2022/08/17 06:00
CRDT- 2022/06/30 22:03
PHST- 2022/02/16 00:00 [received]
PHST- 2022/05/15 00:00 [revised]
PHST- 2022/05/17 00:00 [accepted]
PHST- 2022/07/01 06:00 [pubmed]
PHST- 2022/08/17 06:00 [medline]
PHST- 2022/06/30 22:03 [entrez]
AID - S0002-9149(22)00585-9 [pii]
AID - 10.1016/j.amjcard.2022.05.023 [doi]
PST - ppublish
SO  - Am J Cardiol. 2022 Sep 1;178:72-79. doi: 10.1016/j.amjcard.2022.05.023. Epub 2022 
      Jun 28.