The impact of exercise training on endothelial function in heart failure patients: a systematic review
Abstract9.1 BACKGROUND Flow mediated dilatation (FMD) is attenuated in Heart failure (HF) and this leads to worsening of symptoms. In Europe, the number of HF patients is estimated to be approximately 15 million and that number is set to rise due to ageing of the population. A research conducted between 1999 and 2000, showed that mortality rate was 50% in males and 46% in female within 5 years after the diagnosis of HF. It is estimated that 50% die within four years whereas the other 50% do not survive beyond the first year after diagnosis. Endothelial dysfunction has been implicated in disease progression, however, it is known that increase in physical activity improves and corrects endothelial dysfunction. 9.2 OBJECTIVES The aim of this systematic review is to examine (i) the effect of exercise modalities (aerobic, strength or combined) on FMD in HF and (ii) to determine which modality confers the greatest benefit and to what extent. 9.3 METHOD The following databases (MEDLINE, Cochrane library, PubMed, science direct,) were searched for sources that met the inclusion criteria such as (i) randomized controlled trials of 31 exercise with non-exercise, routine care or sedentary lifestyle. (ii) Duration of the exercise should be at least 2 weeks (iii) age of participant should not be below 18 years. (iv) Endothelial function as measured by FMD before and after the intervention. 9.4 RESULTS 14 studies were included in this review with a total of 583 participants predominantly with reduced ejection fraction (<40%) and New York Heart Association II and III. Compared with control, there were significant improvement (p< 0.005) in endothelial function as measured by FMD in the exercise group across all the studies involving HF with reduced ejection fraction (HFREF). Aerobic exercise at a moderate intensity resulted in significant increase in FMD in 12 studies but higher outcome were noted when it was performed in combination with resistance training at a higher intensity. Conversely, one study done among HF with preserved ejection fraction (HFPEF) did not show any significant improvement. 9.5 CONCLUSION Exercise training is effective in correcting the prevailing endothelial dysfunction common with HF. Combination of aerobic and resistance training as against only aerobic at moderate to high intensity offers the greatest benefit.
CitationObinna, N. P. (2015). The impact of exercise training on endothelial function in heart failure patients: a systematic review. (Master's thesis). University of Chester, United Kingdom.
PublisherUniversity of Chester
TypeThesis or dissertation
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