Research Article

Meta-Analysis of the Effects of Cardiac Rehabilitation on Exercise Tolerance and Cardiac Function in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy

Table 1

The characteristics of the included studies.

AuthorYearSample sizeFollow-up time (months)Peak VO2 (ml/kg/min, mean ± SD)LVEF (%)CR protocol (a: duration, b: frequency, c: exercise mode, d: intensity)OutcomeAdverse events
ControlCRControlCRControlCR

Patwala et al. [12]20092525318.07 ± 3.8920.1 ± 3.8435.0 ± 7.237.3 ± 5.4(a) 12 weeks
(b) 3 sessions/week
(c) aerobic exercise, each session consisted of 10 min of treadmill walking, 10 min of cycling, and 10 min of treadmill walking
(d) moderate to high intensity, 80% of the peak heart rate achieved in the first 4 weeks, 85% in the next 4 weeks, and 90% in the final 4 weeks
Peak VO2, NYHA class, exercise duration, QOL, several other measures of cardiopulmonary fitness, echocardiographic measuresNo patients had any adverse events from the exercise training

Belardinelli et al. [13]20061015215.8 ± 2.117.9 ± 2.333 ± 642 ± 5(a) 8 weeks
(b) 3 sessions/week
(c) aerobic exercise, each session consisted of 15 min of stretching exercises, 40 min of cycling, and 5 min of loadless recovery
(d) moderate intensity, 60% of the peak VO2
Peak VO2, functional capacity, QOL, hospital readmission, echocardiographic measuresNo patients had any adverse events from the exercise training

Nobre et al. [14]20161614419.7 ± 1.221.6 ± 1.529 ± 233 ± 4(a) 4 months
(b) 3 sessions/week
(c) aerobic exercise, each session consisted of 5 min of stretching exercises, 40 min of treadmill walking, 10 min of local strengthening exercises, and 5 min of cool down with stretching exercises
(d) moderate intensity, established by heart rate levels that corresponded to the anaerobic threshold up to 10% below the respiratory compensation point obtained in the cardiopulmonary exercise test
Peak VO2, muscle sympathetic nerve activity, exercise duration, echocardiographic measures, forearm blood flow, Ca2+ handling gene expression in vastus lateralis muscleN/A

Smolis-Bak et al. [15]201526263-4/1213.4 ± 4.217.2 ± 3.9(a) 11 months
(b) initial exercise training in the hospital setting for 3 weeks on average, then at home with telemonitoring for 5 sessions/week
(c) aerobic exercise, active exercises of small and subsequently larger muscle groups of the lower and upper limbs, respiratory exercises, range-of-motion exercises of the shoulder joint on the implantation side
(d) low intensity
Peak VO2, peak VCO2, treadmill test duration, echocardiographic measures, QOLNo significant differences in ICD interventions, mortality, or hospitalization rates between the groups

CR: cardiac rehabilitation; peak VO2: peak oxygen uptake; peak VCO2: peak carbon dioxide elimination; LVEF: left ventricular ejection fraction; QOL: quality of life; N/A: not available; ICD: implantable cardioverter-defibrillator.