The Effectiveness of Lifestyle Interventions in Heart Failure With Preserved Ejection Fraction: A Systematic Review and Network Meta-Analysis.
J Card Fail
; 30(8): 994-1009, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-38428727
ABSTRACT
OBJECTIVES:
To perform a network meta-analysis to determine the effectiveness of lifestyle interventions in exercise tolerance and quality of life (QoL) in people with HFpEF.METHODS:
Ten databases were searched for randomized controlled trials that evaluated a diet and/or exercise intervention in people with heart failure with preserved ejection fraction until May 2022. The co-primary outcomes were peak oxygen uptake (VÌO2peak) and Quality of Life as assessed by the Minnesota Living with Heart Failure Questionnaire (MLHFQ). We synthesized data using network meta-analysis.RESULTS:
We identified 13 trials, including a total of 869 participants, and we incorporated 6 different interventions. Improvements in VÌO2peak compared to controls were seen for all exercise interventions (2.88 [95% CI 1.36; 4.39] mL/kg/min) for high-intensity interval training (HIIT); 2.37 [95% CI 1.02; 3.71] mL/kg/min for low-intensity exercise (LIT) combined with a hypocaloric diet; 2.05 [95% CI 0.81; 3.29] mL/kg/min for moderate-intensity continuous training (MICT); 1.94 [95% CI 0.59; 3.29] mL/kg/min for LIT; 1.85 [95% CI 0.27; 3.44] mL/kg/min for MICT combined with resistance training) but not a hypocaloric diet alone (1.26 [95%CI -0.08; 2.61] mL/kg/min). Only HIIT (-14.45 [95%CI -24.81; -4.10] points) and LIT (95% CI -11.05 [-20.55; -1.54] mL/kg/min) significantly improved MLHFQ scores. Network meta-analysis indicated that HIIT was the most effective intervention for improving both VÌO2peak (mean improvement 2.88 [95% CI 1.36; 4.39] mL/kg/min, follow-up range, 4 weeks-3 years) and QoL (-14.45 [95% CI -24.81; -4.10] points, follow-up range, 12-26 weeks) compared to usual care.CONCLUSIONS:
This network meta-analysis indicates that HIIT is the most effective lifestyle intervention studied to improve exercise capacity and QoL, with mean improvements exceeding the minimum clinically meaningful thresholds. HIIT is likely to be an underused management strategy in HFpEF, but further studies are needed to confirm long-term improvements in symptoms and clinical outcomes.Palabras clave
Texto completo:
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Banco de datos:
MEDLINE
Asunto principal:
Volumen Sistólico
/
Metaanálisis en Red
/
Insuficiencia Cardíaca
Límite:
Humans
Idioma:
En
Revista:
J Card Fail
Asunto de la revista:
CARDIOLOGIA
Año:
2024
Tipo del documento:
Article