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Cardiac Rehabilitation in patient with heart Failure: a meta analysis

摘要Background<br>  We performed a meta-analysis to assess the association between cardiac rehabilitation and heart failure.<br>  Although exercise training for heart failure (HF) patients was previously discouraged due to concerns of worsening symptoms and detriment to the disease process itself, evidence supports a role for exercise training in this population as a means of reversing cardiac and skeletal muscle abnormalities, and improving functional status, quality of life, and clinical outcomes x<br>  Methods and Results<br>  To identify all relevant studies, a computerized literature search was performed in the electronic database Pub Med using the following terms: “Heart Failure” and“Cardiac Rehabilitation”. The potential relationship between cardiac rehabilitation and heart failure has been widely investigated. Studies were selected using a priori defined Criteria, and each study was reviewed by 2 authors who abstracted data on study characteristics, study quality, and outcomes.The present meta-analysis was conducted in an attempt to provide a more robust synthesis conclusion. Pub Med were used to search for all relevant studies published on or before December 2013. Eight studies with a total of 1093 patients who met the inclusion criteria were included in this meta-analysis<br>  Odds ratios or weighted means and 95% confidence intervals (CIs) were then calculated and pooled using a fixed-effects mode or a random-effect model, depending on the heterogeneity among the included studies. Statistical heterogeneity was evaluated through the use of I2 statistics.<br>  Our results demonstrate that Systolic Blood Pressure (Mean Difference) MD-5.18, 95%CI-12.73 to 2.37, z=1.34, p=0.18), Heart Rate(MD-1.81, 95%CI -7.00 to 3.38, Z=0.68, p=0.49), Ejection Fraction(MD 0.10, 95% CI -3.79 to 6.95. z=0.58, p=0.56), VO2 ml/min(MD 91.72, 95%CI -292.13 to 475.57. Z=0.47, p=0.64), Hospital Admission (OR 0.61, 95%CI 0.31 to 1.19. z=1.46, p=0.14), Mortality (OR 0.58, 95%CI 0.29 to 1.15. z=1.56, p=0.12)<br>  Conclusions:<br>  The present study shows these results. Meta analysis done for cardiac rehabilitation and heart failure for the article published before December 2013 with six outcomes systolic blood pressure, heart rate, ejection fraction, Vo2 ml/min, hospital admission and mortality from included article and data was analysed in review manager for the results. Results came for analysed data was not satisfactory. Although i2 values suggest good result but the value of p is negative. So according to this result cardiac rehabilitation didn’t support to systolic blood pressure, heart rate, ejection fraction, Vo2 ml/min , hospital admission and mortality.

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