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Open Access 13-07-2022 | Pulmonary Hypertension

The effect of exercise training and physiotherapy on left and right heart function in heart failure with preserved ejection fraction: a systematic literature review

Authors: Eglė Palevičiūtė, Toma Šimbelytė, Christina A. Eichstaedt, Nicola Benjamin, Benjamin Egenlauf, Ekkehard Grünig, Jelena Čelutkienė

Published in: Heart Failure Reviews | Issue 1/2023

Abstract

The impact of exercise training and physiotherapy on heart function and pulmonary circulation parameters in heart failure with preserved ejection fraction (HFpEF) patients is uncertain. Hence, we performed a systematic review of published trials studying physical training in HFpEF population, with a focus on exercise and physiotherapy effect on left ventricular (LV), right ventricular (RV) morphological, functional, and pulmonary circulation parameters. We searched Cochrane Library and MEDLINE/PubMed for trials that evaluated the effect of exercise training and/or physiotherapy in adult HFpEF patients (defined as LVEF ≥ 45%), including publications until March 2021. Our systematic review identified eighteen articles (n = 418 trained subjects, 4 to 52 weeks of training) and covered heterogeneous trials with various populations, designs, methodologies, and interventions. Five of twelve trials revealed a significant reduction of mitral E/e’ ratio after the training (− 1.2 to − 4.9). Seven studies examined left atrial volume index; three of them showed its decrease (− 3.7 to − 8 ml/m²). Findings were inconsistent regarding improvement of cardiac output, E/A ratio, and E wave DecT and uncertain for RV function and pulmonary hypertension parameters. For now, no reliable evidence about rehabilitation effect on HFpEF cardiac mechanisms is available. There are some hypotheses generating findings on potential positive effects to parameters of LV filling pressure (E/e’), left atrium size, cardiac output, and RV function. This encourages a broader and more complex assessment of parameters reflecting cardiac function in future HFpEF exercise training studies.

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Title: The effect of exercise training and physiotherapy on left and right heart function in heart failure with preserved ejection fraction: a systematic literature review
Authors: Eglė Palevičiūtė
Toma Šimbelytė
Christina A. Eichstaedt
Nicola Benjamin
Benjamin Egenlauf
Ekkehard Grünig
Jelena Čelutkienė
Publication date: 13-07-2022
Publisher: Springer US
Keywords: Pulmonary Hypertension
Heart Failure
Pulmonary Hypertension
Pulmonary Hypertension
Pulmonary Hypertension
Published in: Heart Failure Reviews / Issue 1/2023
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI: https://doi.org/10.1007/s10741-022-10259-1

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