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Eur. J. Heart Fail. · Jul 2014
Review Meta AnalysisEffects of exercise training on depression in patients with heart failure: a systematic review and meta-analysis of randomized controlled trials.
- Rong-Hui Tu, Zhi-Yu Zeng, Guo-Qiang Zhong, Wei-Feng Wu, Yun-Juan Lu, Zhan-Dong Bo, Yan He, Wei-Qiang Huang, and Li-Mei Yao.
- Department of Geriatric Cardiology, First Affiliated Hospital, Guang Xi Medical University, Nanning, China.
- Eur. J. Heart Fail. 2014 Jul 1; 16 (7): 749-57.
AimsThe aim of this review is to assess the effects of exercise training on the symptoms of depression in heart failure (HF) patients.Methods And ResultsRandomized controlled trials of exercise training in patients with HF and symptoms of depression were identified. The depression data were pooled using meta-analysis, and 19 studies were identified, with a total of 3447 patients, of which 16 (3226 patients) provided data for the meta-analysis. Exercise training demonstrated significant reductions in the symptoms of depression [standardized mean difference (SMD) -0.38, 95% confidence interval (CI) -0.55 to -0.21], and its antidepressive effect was consistent in a number of HF groups, such as in ages under and over 65 years (SMD -0.14, 95% CI -0.22 to -0.07 vs. SMD -0.44, 95% CI -0.61 to -0.27) and EFs of <50% (SMD -0.38, 95% CI -0.56 to -0.20), as well as in a range of interventional strategies, including the aerobic mode (SMD -0.40, 95% CI -0.61 to -0.19), centre, home, or combined setting (SMD -0.61, 95% CI -0.95 to -0.27 vs. SMD -0.25, 95% CI -0.44 to -0.07 vs. SMD -0.13, 95% CI -0.21 to -0.05), and short or longer training programmes (≤12 weeks, SMD -0.50, 95% CI -0.73 to -0.27; 12-26 weeks, SMD -0.47, 95% CI -0.82 to -0.11; >26 weeks, SMD -0.12, 95% CI -0.20 to -0.04). The beneficial effects were preserved when blind design trials were considered (SMD -0.14, 95% CI -0.22 to -0.07).ConclusionExercise training significantly decreased the symptoms of depression in patients with HF. This benefit remained unclear in cases of HF with a normal EF and combined aerobic and strength training. Random controlled trials are needed to verify the benefit of exercise in these populations, and in very old, asymptomatic, and severe HF patients.© 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.
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