PMID- 37499852
OWN - NLM
STAT- MEDLINE
DCOM- 20240503
LR  - 20240503
IS  - 1532-821X (Electronic)
IS  - 0003-9993 (Linking)
VI  - 105
IP  - 5
DP  - 2024 May
TI  - Non-Pharmacological Interventions in Patients With Heart Failure With Reduced 
      Ejection Fraction: A Systematic Review and Network Meta-analysis.
PG  - 963-974
LID - S0003-9993(23)00410-0 [pii]
LID - 10.1016/j.apmr.2023.07.004 [doi]
AB  - OBJECTIVE: To determine the effectiveness of non-pharmacologic interventions and 
      the additional benefits of their combination in patients with heart failure with 
      reduced ejection fraction (HFrEF). DATA SOURCES: We searched PubMed, Embase, and 
      the Cochrane Clinical Trials Register from the date of database inception to 
      April 22, 2023. STUDY SELECTION: Randomized controlled trials involving 
      non-pharmacologic interventions conducted in patients with HFrEF were included. 
      DATA EXTRACTION: Data were extracted by 2 independent reviewers based on a 
      pre-tested data extraction form. The quality of evidence was assessed using the 
      Cochrane Risk of Bias tool and the Grading of Recommendations Assessment, 
      Development, and Evaluation method. DATA SYNTHESIS: A total of 82 eligible 
      studies (4574 participants) were included. We performed a random-effects model 
      within a Bayesian framework to calculate weighted mean differences (WMDs) and 95% 
      credibility intervals. High or moderate certainty evidence indicated that 
      high-intensity aerobic interval training (HIAIT) was best on improving 6-minute 
      walk distance (6MWD; 68.55 m [36.41, 100.47]) and left ventricular ejection 
      fraction (6.28% [3.88, 8.77]), while high-intensity aerobic continuous training 
      (HIACT) is best on improving peak oxygen consumption (Peak VO(2); 3.48 mL/kg*min 
      [2.84, 4.12]), quality of life (QOL; -17.26 [-29.99, -7.80]), resting heart rate 
      (-8.20 bpm [-13.32, -3.05]), and N-terminal pro-B-type natriuretic peptide 
      (-600.96 pg/mL [-902.93, -404.52]). Moderate certainty evidence supported the 
      effectiveness of inspiratory muscle training to improve peak oxygen consumption 
      and functional electrical stimulation to improve QOL. Moderate-intensity aerobic 
      continuous training (MIACT) plus moderate-intensity resistance training (MIRT) 
      had additional benefits in Peak VO(2), 6MWD, and QOL. This review did not provide 
      a comprehensive evaluation of adverse events. CONCLUSIONS: Both HIAIT and HIACT 
      are the most effective single non-pharmacologic interventions for HFrEF. MIACT 
      plus MIRT had additional benefits in improving peak oxygen consumption, 6MWD, and 
      QOL.
CI  - Copyright (c) 2023 American Congress of Rehabilitation Medicine. Published by 
      Elsevier Inc. All rights reserved.
FAU - Li, Yilun
AU  - Li Y
AD  - School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
FAU - He, Wenbo
AU  - He W
AD  - Institute of Hospital Management, West China Hospital of Sichuan University, 
      Chengdu, Sichuan, China; Saw Swee Hock School of Public Health, National 
      University of Singapore, Singapore, Singapore.
FAU - Jiang, Jingwen
AU  - Jiang J
AD  - School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
FAU - Zhang, Jiawen
AU  - Zhang J
AD  - School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
FAU - Ding, Mingfeng
AU  - Ding M
AD  - School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
FAU - Li, Gaiyun
AU  - Li G
AD  - School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
FAU - Luo, Xiaolei
AU  - Luo X
AD  - School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
FAU - Ma, Ziyuan
AU  - Ma Z
AD  - School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
FAU - Li, Jingyi
AU  - Li J
AD  - School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
FAU - Ma, Yichen
AU  - Ma Y
AD  - School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
FAU - Shen, Yanfei
AU  - Shen Y
AD  - Office of Legal Affairs, Gansu Provincial Hospital, Lanzhou, Gansu, China.
FAU - Han, Xuemei
AU  - Han X
AD  - School of Public Health, Lanzhou University, Lanzhou, Gansu, China. Electronic 
      address: xmhan@lzu.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20230725
PL  - United States
TA  - Arch Phys Med Rehabil
JT  - Archives of physical medicine and rehabilitation
JID - 2985158R
SB  - IM
MH  - Humans
MH  - *Heart Failure/rehabilitation/physiopathology/therapy
MH  - *Stroke Volume/physiology
MH  - *Network Meta-Analysis
MH  - Exercise Therapy/methods
MH  - Randomized Controlled Trials as Topic
MH  - Quality of Life
MH  - High-Intensity Interval Training/methods
MH  - Walk Test
OTO - NOTNLM
OT  - Heart failure
OT  - Network meta-analysis
OT  - Non-pharmacologic interventions
OT  - Rehabilitation
OT  - Systematic review
EDAT- 2023/07/28 01:08
MHDA- 2024/05/04 11:50
CRDT- 2023/07/27 19:15
PHST- 2022/11/30 00:00 [received]
PHST- 2023/06/15 00:00 [revised]
PHST- 2023/07/05 00:00 [accepted]
PHST- 2024/05/04 11:50 [medline]
PHST- 2023/07/28 01:08 [pubmed]
PHST- 2023/07/27 19:15 [entrez]
AID - S0003-9993(23)00410-0 [pii]
AID - 10.1016/j.apmr.2023.07.004 [doi]
PST - ppublish
SO  - Arch Phys Med Rehabil. 2024 May;105(5):963-974. doi: 10.1016/j.apmr.2023.07.004. 
      Epub 2023 Jul 25.