Aerobic Training Intensity for Improved Endothelial Function in Heart Failure Patients: A Systematic Review and Meta-Analysis

Abstract

Objective. Flow-mediated dilation (FMD) is widely utilised to assess endothelial function and aerobic exercise improves FMD in heart failure patients. The aim of this meta-analysis is to quantify the effect of aerobic training intensity on FMD in patients with heart failure. Background. A large number of studies now exist that examine endothelial function in patients with heart failure. We sought to add to the current literature by quantifying the effect of the aerobic training intensity on endothelial function. Methods. We conducted database searches (PubMed, Embase, ProQuest, and Cochrane Trials Register to June 30, 2016) for exercise based rehabilitation trials in heart failure, using search terms exercise training, endothelial function, and flow-mediated dilation (FMD). Results. The 13 included studies provided a total of 458 participants, 264 in intervention groups, and 194 in nonexercising control groups. Both vigorous and moderate intensity aerobic training significantly improved FMD. Conclusion. Overall both vigorous and moderate aerobic exercise training improved FMD in patients with heart failure.

Effect of exercise therapy on established and emerging circulating biomarkers in patients with heart failure: a systematic review and meta-analysis

“…While moderate continuous training (MCT) has been the cornerstone of conventional HF training, over the past decade, the interest in high-intensity interval training (HIIT) has grown 85. Two studies included in the review that specifically incorporated HIIT and MCT groups for comparative purposes observed significant improvements in BNP57 and NT-proBNP47 from HIIT, with no significant change from MCT.…”

Rethinking Endothelial Dysfunction as a Crucial Target in Fighting Heart Failure

“…A growing number of clinical trials are investigating the effect of exercise on endothelial function in patients with HF and HFpEF 75 . In a 458 patient meta-analysis, Pearson and Smart 76 revealed that aerobic exercise significantly improves FMD in patients with HF, suggesting that improving endothelial function via cardiac rehabilitation may be an important therapy for patients with HF. Indeed, Tanaka et al 77 recently reported that cardiac rehabilitation improved prognosis in patients with HF, although with a greater effect on patients with HFrEF than HFpEF, and this improvement was attributed to the impact on improving endothelial function.…”

The acute and long-term effects of a cardiac rehabilitation program on endothelial progenitor cells in chronic heart failure patients: Comparing two different exercise training protocols

“…During the last decades, endothelial progenitor cells (EPCs) have been used as an index of the endothelium restoration potential, therefore reflecting the vascular endothelial function [4] . Regular aerobic exercise has a beneficial impact in the function of the vascular endothelium and EPCs [5] , [6] , [7] . Different modalities, namely high-intensity interval and continuous ones, have been shown to enhance the stimulation of EPCs from the bone marrow and mature endothelial cells also known as circulating endothelial cells (CECs), positively influencing their number or their functional properties in patients with comorbidities and increased risk factors.…”