Evidence map›Paper›PMID 24622004›Full record

SynthesisJACC. Heart failure2013

Clinical outcomes and cardiovascular responses to different exercise training intensities in patients with heart failure: a systematic review and meta-analysis.

Hashbullah Ismail, James R McFarlane, A Hadi Nojoumian, Gudrun Dieberg, Neil A Smart

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in JACC. Heart failure, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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

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  15. Dietary Nitrate Increases VOJournal of cardiac failure · 2018
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7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Hashbullah IsmailSchool of Science and Technology, University of New England, Armidale, Australia.
James R McFarlaneSchool of Science and Technology, University of New England, Armidale, Australia.
A Hadi NojoumianSchool of Science and Technology, University of New England, Armidale, Australia.
Gudrun DiebergSchool of Science and Technology, University of New England, Armidale, Australia.
Neil A SmartSchool of Science and Technology, University of New England, Armidale, Australia. Electronic address: nsmart2@une.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe aim of this study was to establish whether aerobic exercise training intensity produces different effect sizes for fitness, adherence, event rates, mortality rates, and hospitalization rates in patients with heart failure.

backgroundIntuitively, greater exercise intensity is considered to result in higher risk for serious events, but intensity may be the primary stimulus for physical adaptation.

methodsA MEDLINE search (1985 to 2012) was conducted for exercise-based rehabilitation trials in heart failure, using the search terms "exercise training," "left ventricular dysfunction," "peak Vo2," "cardio-myopathy," and "systolic heart dysfunction." Seventy-four studies were included, producing 76 intervention groups; 9 (11.8%) were high-intensity, 38 (50%) vigorous-intensity, 24 (31.6%) moderate-intensity, and 5 (6.6%) low-intensity groups, providing a total of 3,265 exercising subjects and 2,612 control subjects.

resultsPeak oxygen consumption increased by a mean difference of 3.33 ml·kg(-1)·min(-1) (95% confidence interval [CI]: 0.53 to 6.13 ml·kg(-1)·min(-1); p = 0.02) with high-intensity training in exercise groups compared with control groups, equating to a 23% improvement from baseline. For vigorous intensity, the mean difference was 2.27 ml·kg(-1)·min(-1) (95% CI: 1.70 to 2.84 ml·kg(-1)·min(-1); p < 0.00001), with an 8% weighted mean; for moderate intensity, the mean difference was 2.17 ml·kg(-1)·min(-1) (95% CI: 1.34 to 2.99 ml·kg(-1)·min(-1); p < 0.00001), with a weighted mean of 13%; and for low intensity, the mean difference was 1.04 ml·kg(-1)·min(-1) (95% CI: -2.50 to 4.57 ml·kg(-1)·min(-1); p = 0.57), with a weighted mean of 7%. In 123,479 patient-hours of training, not a single death was directly attributable to exercise.

conclusionsAs exercise training intensity rises, so may the magnitude of improvement in cardiorespiratory fitness, accompanied by lower study withdrawal in exercising patients. Total exercise time may be a confounder.

Indexed as

Exercise TherapyHeart FailureHospitalizationHumansOxygen ConsumptionRandomized Controlled Trials as TopicTreatment Outcomecardiorespiratory fitnessexercise intensityheart failurehospitalizationmortality

Identifiers

PMID24622004

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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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.