Evidence map›Paper›PMID 30922474›Full record

SynthesisJournal of the American College of Cardiology2019

Impact of Exercise Rehabilitation on Exercise Capacity and Quality-of-Life in Heart Failure: Individual Participant Meta-Analysis.

Rod S Taylor, Sarah Walker, Neil A Smart, Massimo F Piepoli, Fiona C Warren, Oriana Ciani, David Whellan, Christopher O'Connor, Steven J Keteyian, Andrew Coats and 11 more

4 registry-linked trialsAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the American College of Cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 124 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
124citing papers in PubMed, 18 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.

NCT06396793 completednot on this mapstarted 2023, after this paper: background citation

Prevalence of Psychological Symptoms and Their Correlation With the Rehabilitative Outcome in Patients With Cardiac and Pulmonary Diseases Undergoing a Hospital Rehabilitation.

TypeobservationalSponsorIstituti Clinici Scientifici Maugeri SpARan2023 to 2024Enrolled421ConditionsPsychological Distress, Anxiety, Depression, Cardiovascular DiseasesArmsno intervention because it is an observational study
NCT06481657 nacompletednot on this mapstarted 2022, after this paper: background citation

The Effect of Oxygen Supplementation in Training in Heart Failure Patients on Aerobic Performance and Quality of Life

TypeinterventionalSponsorLaniado HospitalRan2022 to 2023Enrolled24ConditionsHeart Failure With Reduced Ejection Fraction, Heart Failure With Mid Range Ejection FractionArmstrain with oxygen and without oxygen enrichment (placebo).
NCT06795737 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Effectiveness and Safety of Exercise-based Cardiac Rehabilitation (ExCR) During the Vulnerable Period in Patients With Acute Decompensated Heart Failure (ADHF): A Randomized Controlled Trial

TypeinterventionalSponsorYE JingRan2025 to 2026Enrolled88ConditionsAcute Decompensated Heart Failure (ADHF)ArmsExercise rehabilitation, Conventional rehabilitation
NCT07023536 recruitingnot on this mapstarted 2025, after this paper: background citation

Evaluation of the Effectiveness of a Cardiac Telerehabilitation Program in Chronic Heart Failure

TypeobservationalSponsorUniversity of SalernoRan2025 to 2026Enrolled205ConditionsHeart FailureArmsTELEREHABILITATION-YES, TELEREHABILITATION-NO
3 · Its place in the literature

Who cites it

124 citing papers in PubMed, 18 syntheses or guidelines pooled it.

  1. Apathy and Physical Activity: A Systematic Review and Meta-Analysis.Physiotherapy Canada. Physiotherapie Canada · 2026
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  10. Home-based versus centre-based cardiac rehabilitation.The Cochrane database of systematic reviews · 2023
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64 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors.

Rod S TaylorInstitute of Health Research, College of Medicine and Health, University of Exeter and Institute of Health and Well Being, University of Glasgow, Glasgow, United Kingdom. Electronic address: r.taylor@exeter.ac.uk.
Sarah WalkerInstitute of Health Research, University of Exeter Medical School, Exeter, United Kingdom. Electronic address: https://twitter.com/Sarah1003Walker.
Neil A SmartUniversity of New England, Armidale, New South Wales, Australia.
Massimo F PiepoliCardiology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy.
Fiona C WarrenExeter Collaboration for Academic Primary Care, Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom.
Oriana CianiInstitute of Health Research, University of Exeter Medical School, Exeter, United Kingdom; Centre for Research on Health and Social Care Management, Bocconi University, Milan, Italy.
David WhellanDepartment of Medicine, Sidney Kimmel Medical College, Philadelphia, Pennsylvania.
Christopher O'ConnorDuke Clinical Research Institute, Durham, North Carolina.
Steven J KeteyianDepartment of Medicine, Henry Ford Hospital, Detroit, Michigan.
Andrew CoatsIRCCS, San Raffaele, Pisana, Italy.
Constantinos H DavosCardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece.
Hasnain M DalalInstitute of Health Research, University of Exeter Medical School, Exeter, United Kingdom; Research, Development & Innovation, Royal Cornwall Hospital, Truro, United Kingdom.
Kathleen DracupSchool of Nursing, University of California San Francisco, San Francisco, California.
Lorraine S EvangelistaUniversity of California Irvine, Irvine, California.
Kate JollyInstitute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.
Jonathan MyersVA Palo Alto Health Care System/Stanford University, Stanford, California.
Birgitta B NilssonDivision of Medicine, Oslo University Hospital and Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Claudio PassinoFondazione G. Monasterio and Scuola Superiore Sant'Anna, Pisa, Italy.
Miles D WithamNIHR Newcastle Biomedical Research Centre, Institute of Neuroscience, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom.
Gloria Y YehBeth Israel Deaconess Medical Center, Department of Medicine, Boston, Massachusetts.
ExTraMATCH II Collaboration

Funding

Tai Chi Mind-Body Therapy for Chronic Heart FailureR01AT002454 · NCCIH · BETH ISRAEL DEACONESS MEDICAL CENTER · PI PHILLIPS, RUSSELL SCOTT · 2004 to 2007
$2.3M
Mentoring and Patient-Oriented Research in Mind-Body ExerciseK24AT009465 · NCCIH · BETH ISRAEL DEACONESS MEDICAL CENTER · PI GLORIA Y YEH · 2017 to 2026
$1.3M
Fitness Intensive Therapy (Get FIT) to Promote Healthy Living in Older AdultsR21AG053162 · NIA · UNIVERSITY OF CALIFORNIA-IRVINE · PI EVANGELISTA, LORRAINE S · 2018 to 2019
$425k
Department of Health NIHR-HTA 15/80/30Department of Health RP-DG-0709-10111Department of Health RP-PG-1210-12004NCCIH NIH HHS K24 AT009465NCCIH NIH HHS R01 AT002454NIA NIH HHS R21 AG053162
6 · The paper itself

Abstract

backgroundPrevious systematic reviews have indicated that exercise-based cardiac rehabilitation (ExCR) for patients with heart failure (HF) has a beneficial effect on health-related quality-of-life (HRQoL) and exercise capacity. However, there is uncertainty regarding potential differential effects of ExCR across HF patient subgroups.

objectivesThe authors sought to undertake an individual participant data (IPD) meta-analysis to: 1) assess the impact of ExCR on HRQoL and exercise capacity in patients with HF; and 2) investigate differential effects of ExCR according to a range of patient characteristics: age, sex, ethnicity, New York Heart Association functional class, ischemic etiology, ejection fraction, and exercise capacity.

methodsA single dataset was produced, comprising randomized trials where ExCR (delivered for 3 weeks or more) was compared with a no exercise control group. Each trial provided IPD on HRQoL or exercise capacity (or both), with follow-up of 6 months or more. One- and 2-stage meta-analysis models were used to investigate the effect of ExCR overall and the interactions between ExCR and participant characteristics.

resultsIPD was obtained from 13 trials for 3,990 patients, predominantly (97%) with reduced ejection fraction HF. Compared with the control group, there was a statistically significant difference in favor of ExCR for HRQoL and exercise capacity. At 12-month follow-up, improvements were seen in 6-min walk test (mean 21.0 m; 95% confidence interval: 1.57 to 40.4 m; p = 0.034) and Minnesota Living With HF score (mean improvement 5.9; 95% confidence interval: 1.0 to 10.9; p = 0.018). No consistent evidence was found of differential intervention effects across patient subgroups.

conclusionsThese results, based on an IPD meta-analysis of randomized trials, confirm the benefit of ExCR on HRQoL and exercise capacity and support the Class I recommendation of current international clinical guidelines that ExCR should be offered to all HF patients. (Exercise Training for Chronic Heart Failure [ExTraMATCH II]: protocol for an individual participant data meta-analysis; PROSPERO: international database of systematic reviews CRD42014007170).

Indexed as

Cardiac RehabilitationExercise ToleranceHeart FailureQuality of LifeExercise TherapyHumansRandomized Controlled Trials as Topicexercise capacityheart failureMLHFQQoLquality-of-liferehabilitation

Identifiers

PMID30922474
PMCPMC8351793

What OpenQuestion holds

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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.