Cardiology · 3 h ago
Meta-analysis estimates exercise doses associated with fitness gains in heart failure
A Bayesian network dose–response meta-analysis of 100 randomized trials involving 5,353 patients with heart failure compared exercise modalities and their effects on peak oxygen uptake. The analysis found an Emax dose–response pattern, with estimated benefits varying by modality and exercise tolerance.
- Included 100 randomized trials and 5,353 patients with heart failure.
- Dose–response estimates followed an Emax curve.
- 500 MET-min/week was associated with considerable fitness benefit.
- Modality suggestions are preliminary and based on VO2peak.
Researchers searched multiple databases through March 2026 for randomized controlled trials comparing exercise interventions with controls in patients with heart failure. They included 100 trials and 5,353 patients, grouping interventions as interval or continuous aerobic training, resistance training, mind–body training, and combinations. Exercise dose was standardized as weekly metabolic equivalents (MET-min/week), and the primary outcome was peak oxygen uptake (VO2peak).
The dose–response relationship followed an Emax curve, with estimated ED50 values clustering around 80–90 MET-min/week. A weekly dose of 500 MET-min was associated with considerable benefit, while 750–1,000 MET-min approached maximal benefit for nearly all modalities. Interval aerobic training, resistance training, and their combination ranked among the highest for estimated maximal effect; their respective Emax estimates were 3.50, 3.66, and 3.49.
The authors offer preliminary modality considerations according to exercise tolerance and comorbid obesity. These findings concern VO2peak, and the abstract does not provide details on clinical outcomes, adverse events, or the certainty and limitations of the evidence. The proposed modality choices should therefore be interpreted as preliminary rather than definitive exercise-prescription guidance.
In practice
For adults with heart failure undertaking exercise training, this meta-analysis suggests that fitness gains vary with both modality and weekly exercise dose: 500 MET-min/week was associated with considerable benefit, and 750–1,000 MET-min/week approached maximal estimated benefit for most modalities. The authors propose different modality options according to exercise tolerance, but describe these considerations as preliminary. The reported endpoint is peak oxygen uptake; the abstract does not establish effects on clinical outcomes or provide sufficient detail on safety, evidence certainty, or applicability to individual patients, so it does not by itself justify a definitive change in exercise prescription.
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European Journal of Preventive Cardiology: Dose-Response Associations of Exercise Modalities With Cardiorespiratory Fitness in Heart Failure: A Systematic Review and Bayesian Network Meta-Analysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.