# Inspanningsrevalidatie bij HF: IPD meta-analyse van inspanningscapaciteit en QoL

*geplaatst 2019-04-02 · Hartfalen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2018.12.072 · https://hartvaat.nl/2019/04/02/inspanningsrevalidatie-bij-hf-ipd-meta-analyse-van-inspanningscapaciteit-en-qol/*

Individuele patiëntdata meta-analyse naar het effect van inspanningsrevalidatie op inspanningscapaciteit en kwaliteit van leven bij hartfalen.

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

This individual patient data meta-analysis of exercise-based cardiac rehabilitation in heart failure confirmed significant improvements in exercise capacity and quality of life, with the benefit consistent across HFrEF and HFpEF phenotypes.

## Abstract (original, from the publication)

BACKGROUND: Previous 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. OBJECTIVES: The 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. METHODS: A 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. RESULTS: IPD 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. CONCLUSIONS: These 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).

Auteurs: 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, Constantinos H Davos, Hasnain M Dalal, Kathleen Dracup, Lorraine S Evangelista, Kate Jolly, Jonathan Myers, Birgitta B Nilsson, Claudio Passino, Miles D Witham, Gloria Y Yeh

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2018.12.072. Bijgewerkt 2026-07-03T13:27:04Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.