Efficacy and safety of exercise rehabilitation in the vulnerable phase in patients with acute decompensated heart failure: A systematic review and meta-analysis

作者：Lihua Zhao, Jing Ye, Zhuo Zhao, Lei Yang, Yimei Zheng · 发表于：International Journal of Nursing Sciences · 年份：2025 · DOI：10.1016/j.ijnss.2025.06.006 · 被引用次数：2 · 研究领域：Cardiovascular and exercise physiology、Cardiac Health and Mental Health、Heart Failure Treatment and Management

Objectives Assessing the impact of exercise rehabilitation during the vulnerable period on cardiac recovery (CR) outcomes in patients with acute decompensated heart failure (ADHF). Methods PubMed, Web of Science, Embase, the Cochrane Library, CINAHL, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang database, SinoMed, ClinicalTrials.gov, American Heart Association (AHA) and European Society of Cardiology (ESC) were searched for RCTs on exercise rehabilitation in ADHF patients’ vulnerable period. The risk of bias was assessed with Cochrane Risk of Bias 2.0, and data were analyzed in RevMan 5.3. Results A total of seven RCTs involving 946 patients were included. The results demonstrated that exercise rehabilitation training during the vulnerable period in patients with ADHF significantly increased the 6-minute walk test distance (6-MWTD) ( SMD = 0.37; 95 % CI : 0.09, 0.65; P = 0.01), short physical performance battery (SPPB) score ( MD = 1.26; 95 % CI: 0.82, 1.70; P < 0.01) and peak oxygen consumption ( V O 2 peak) ( SMD = 1.43; 95% CI: 0.53, 2.34; P < 0.01), improved quality of life (QoL) ( SMD = 0.85; 95 % CI: 0.07, 1.64, P = 0.03), reduced depression score ( MD = -0.73; 95 % CI: -1.27, -0.18; P < 0.01), frailty ( MD = -0.22; 95 % CI: -0.48, 0.05; P = 0.11), and decreased 6-month all-cause readmission ( OR = 0.67; 95 % CI: 0.49, 0.91; P = 0.01). However, no statistically significant differences were observed betw...