TOPLINE:

Supervised exercise training was safe for recipients of left ventricular assist devices (LVAD) and improved peak oxygen consumption (peak VO₂), walking distance, and quality of life (QOL) compared with standard care, according to a short report presenting a meta-analysis of four randomized controlled trials.

METHODOLOGY:

• Researchers conducted a systematic review and an individual participant data (IPD) meta-analysis of randomized controlled trials to assess whether supervised exercise training was safe and effective in recipients of LVAD.
• They searched six databases for randomized trials that compared supervised exercise training with standard care. The final analysis included four trials from single-centre and multicenter studies across multiple countries between 2011 and 2023.
• The pooled sample included 119 clinically stable ambulatory adults with heart failure and implanted LVAD (mean age, 53 years; 89% men). Standard care included guideline-based management and standard advice on physical activity.
• Exercise training lasted 6-12 weeks, with three to five weekly sessions of 45-60 minutes each. Protocols included aerobic training alone or combined with resistance training, high-intensity inspiratory muscle training, or other complementary modalities.
• Researchers assessed safety, peak VO₂, 6-minute walk test (6MWT) distance, and QOL and explored subgroup effects by age, sex, BMI, time since implantation, and baseline performance on exercise training.

TAKEAWAY:

• Trials reported no serious adverse events related to exercise training. One minor acute event lasted less than 2 hours after a session and resolved before the next session.
• LVAD recipients who received exercise training had a 1.43 mL/kg/min greater increase in peak VO₂ than those who received standard care (P = .004).
• LVAD recipients showed greater improvements with exercise training than with standard care in 6MWT distance (mean difference, +48 m; P < .001) and QOL (standardized mean difference, 0.66 units; P < .001).
• The benefit of exercise training over standard care was greater in men for peak VO₂ (P for interaction = .015) and in patients with BMI less than 25 for 6MWT distance (P for interaction = .038).

IN PRACTICE:

“Our meta-analysis presents the first ever IPD meta-analysis that has demonstrated an excellent safety profile (no serious adverse events) and a greater increase in peak VO₂, 6MWT distance, and QOL following supervised [exercise training] in comparison to [standard care] alone,” the researchers wrote.

SOURCE:

The study was jointly led by Tim Kambič of University of Ljubljana Faculty of Sport in Ljubljana, Slovenia, and Anna Feuerstein, Medical Heart Centre of Charité and German Heart Institute Berlin in Berlin, Germany. It was published online on January 20 as a short report in Heart.

LIMITATIONS:

Sex-based analyses were underpowered because only 13 women were included. Risk for bias may have remained. Follow-up was short and did not include re-hospitalization or mortality outcomes.

DISCLOSURES:

Research of one author received partial funding from the Slovenian Research and Innovation Agency and Erasmus+ staff exchange programme funded by the European Union. Another author reported receiving funding from Slovenian Research and Innovation Agency. Two authors reported receiving personal fees from various pharmaceutical, biotechnology, and healthcare companies including Actimed, Bayer, and AstraZeneca. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.