Evidence map›Paper›PMID 23062530›Full record

Trial reportJournal of the American College of Cardiology2012

Relation between volume of exercise and clinical outcomes in patients with heart failure.

Steven J Keteyian, Eric S Leifer, Nancy Houston-Miller, William E Kraus, Clinton A Brawner, Christopher M O'Connor, David J Whellan, Lawton S Cooper, Jerome L Fleg, Dalane W Kitzman and 5 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03925493 (Exercise Prescription in Cardiac Rehabilitation), which is not on this map. Cited by 78 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03925493 nacompletednot on this mapstarted 2019, after this paper: background citation

Exercise Prescription in Cardiac Rehabilitation: A Pilot Randomized Controlled Trial

TypeinterventionalSponsorBaystate Medical CenterRan2019 to 2020Enrolled48ConditionsPercutaneous Coronary Intervention, Myocardial Infarction, Coronary Artery Bypass GraftArmsGraded Exercise Stress test (GXT) with Target Heart Rate Range, Heart rate monitors
3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 10 syntheses or guidelines pooled it.

  1. Pooled it
  2. Exercise-based cardiac rehabilitation for adults with heart failure.The Cochrane database of systematic reviews · 2024
    Pooled it
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  4. Exercise-based cardiac rehabilitation for adults with heart failure.The Cochrane database of systematic reviews · 2019
    Pooled it
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  6. Pooled it
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  8. Home-based versus centre-based cardiac rehabilitation.The Cochrane database of systematic reviews · 2017
    Pooled it
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  10. Exercise-based rehabilitation for heart failure.The Cochrane database of systematic reviews · 2014
    Pooled it
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  16. Cardiac Rehabilitation Participation Rates and Outcomes for Patients With Heart Failure.Journal of cardiopulmonary rehabilitation and prevention · 2018
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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Steven J KeteyianDivision of Cardiovascular Medicine, Henry Ford Hospital, 6525 Second Avenue, Detroit, Michigan 48202, USA. sketeyi1@hfhs.org
Eric S Leifer
Nancy Houston-Miller
William E Kraus
Clinton A Brawner
Christopher M O'Connor
David J Whellan
Lawton S Cooper
Jerome L Fleg
Dalane W Kitzman
Alain Cohen-Solal
James A Blumenthal
David S Rendall
Ileana L Piña
HF-ACTION Investigators

Funding

ACTION - A CHF Trial Investigating Outcomes of ExerciseU01HL064250 · NHLBI · HENRY FORD HEALTH SYSTEM · PI KETEYIAN, STEVEN J · 2002 to 2007
$1.4M
NHLBI NIH HHS U01 HL064250
6 · The paper itself

Abstract

objectivesThis study determined whether greater volumes of exercise were associated with greater reductions in clinical events.

backgroundThe HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) trial showed that among patients with heart failure (HF), regular exercise confers a modest reduction in the adjusted risk for all-cause mortality or hospitalization.

methodsPatients randomized to the exercise training arm of HF-ACTION who were event-free at 3 months after randomization were included (n = 959). Median follow-up was 28.2 months. Clinical endpoints were all-cause mortality or hospitalization and cardiovascular mortality or HF hospitalization.

resultsA reverse J-shaped association was observed between exercise volume and adjusted clinical risk. On the basis of Cox regression, exercise volume was not a significant linear predictor but was a logarithmic predictor (p = 0.03) for all-cause mortality or hospitalization. For cardiovascular mortality or HF hospitalization, exercise volume was a significant (p = 0.001) linear and logarithmic predictor. Moderate exercise volumes of 3 to <5 metabolic equivalent (MET)-h and 5 to <7 MET-h per week were associated with reductions in subsequent risk that exceeded 30%. Exercise volume was positively associated with the change in peak oxygen uptake at 3 months (r = 0.10; p = 0.005).

conclusionsIn patients with chronic systolic HF, volume of exercise is associated with the risk for clinical events, with only moderate levels (3 to 7 MET-h per week) of exercise needed to observe a clinical benefit. Although further study is warranted to confirm the relationship between volume of exercise completed and clinical events, our findings support the use of regular exercise in the management of these patients.

Indexed as

AgedExerciseExercise TherapyFemaleFollow-Up StudiesHeart FailureHumansMaleMiddle AgedTreatment Outcome

Identifiers

PMID23062530
PMCPMC3804919

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.