Table 2.
Detailed characteristic of all integrated trials.
| Study, year, country | Study design | Population: (a) Data sources (b) Number of included participants (n) (c) Index events (d) Inclusion period (e) other inclusion criteria and characteristics (f) Age (yrs, mean±sd or as stated) (g) Gender (male %) | Intervention: (a) Number (n) (b) CR including exercise only (CR-ex) or multicomponent CR including exercise (CR-mult) (c) Duration (time period and /or total number or CR sessions) (d) Frequency (CR exercise sessions per week) (e) Exercise mode (f) CR setting | Control: (a) Number (n) (b) Treatment | Outcome: (a) Follow-up period (b) Outcome according to CROS_HF -protocol (number according to Table 1) (c) Other outcome | Overall results with respect to CROS-HF-protocol EPs: EP 1: All-cause-mortality EP 2: CV-mortality EP 3: Hospitalization EP 4: Hospitalization due to HF EP 5: Composite endpoint of mortality and hospitalization EP 6: Peak VO2 EP 7: Quality of life | Remarks |
| Belardinelli et al., 1999, Italy21 | RCT | (a) Institutional (b) n=99 (c) HFrEF, LV-EF≤40% (d) NSp (e) Clinically stable ≥3 months (f) 59 ± 14 yrs (g) 88% male | (a) n = 50 (b) CR-ex(c) 14 months (d) 8 wks, 3 sessions/wk, 60 min, one year 2 sessions/wk 60 min (e) Aerobic exercise; 60% peak VO2 (f) Out-patient | (a) n = 49 (b) UC | (a) 14 months (b) 1, 2, 4, 6, 7 (c) Thallium activity score, echo-cardio-graphic results | EP 1: HR 0.37, 95% CI (0.16–0.84) EP 2: Events/patient at risk after 54 months: CR-ex: 9/50 vs UC: 20/49 All deaths were cardiac in nature (see EP 1) EP 4: HR 0.29, 95% CI (0.11–0.84) EP 6: After 12–14 months MD 3.90, 95% CI (3.24–4.56) EP 7: MLWHF 9+ months MD –10, 95% CI (–18.98– –1.02) | |
| Keteyian et al., 1999, USA22 | RCT | (a) Institutional (b) n = 51 (c) HFrEF, LV-EF≤35%, (d) NSp (e) NYHA class II–III, optimal medical therapy≥30 day (f) CR-ex: 57 ± 12 vs UC: 55 ± 12 yrs (g) 100% male | (a) n = 26 (b) CR-ex (c) 6 months (d) 3 sessions/wk, 33 min (e) Aerobic exercise; 50–80% HRR (f) Out-patient | (a) n = 25 (b) UC | (a) 6 months (b) 1, 6, 7 (c) Plasma norepinephrine | EP 1: Events/patient at risk after 6 months: CR-ex: 0/21 vs UC: 1/23 EP 6: After 6 months MD 3.10, 95% CI (0.62–5.58) EP 7: MLWHF up to 6 months MD 5.00, 95% CI (–8.45–18.45) | |
| Myers et al., 2000, Switzerland23 | RCT | (a) Institutional (b) n = 25 (c) HFrEF, LV-EF<40% (d) NSp (e) Clinically stable (f) CR-mult:_ 56 ± 5 vs UC: 55 ± 7 yrs (g) 100% male | (a) n = 12; (b) CR-mult (c) 2 months (d) 2 sessions/day, 60 min walking + 4 sessions/wk 45 min cycle ergometer (e) Aerobic exercise; 60–70% peak VO2 (f) In-patient | (a) n = 13 (b) UC | (a) 12 months (b) 1, 2, 6 (c) Echocardiographic results, physical activity | EP 1: Events/patient at risk after 12 months: CR-mult: 1/12 vs UC: 1/13 EP 2: Events/patient at risk after 12 months: CR-mult: 1/12 vs UC: 0/13 EP 4: Events/patient at risk after 12 months: CR-mult: 0/12 vs UC: 2/13 EP 6: After 12–14 months MD 4.70, 95% CI (0.46–8.94) | |
| Hambrecht et al., 2000, Germany9 | RCT | (a) Institutional (b) n = 73 (c) HFrEF, LV-EF<40% (d) 1994–1999 (e) Aged 70 yrs, PWC>25 watt, clinically stable ≥ 3 months (f) CR-ex: 54 ± 9 vs UC: 55 ± 8 yrs (g) 100% male | (a) n = 36 (b) CR-ex (c) 6 months (d) 2 wks, 4–6 sessions/day, 10 min; 6 months, one session/day 20 min. (e) Aerobic exercise; 70% peak VO2 (f) 2 wks in-hospital, 6 months out-patient/home-based | (a) n = 37 (b) UC | (a) 6 months (b) 1, 4, 6 (c) Echocardiographic results, endothelial function | EP 1: Events/patient at risk after 6 months: CR-ex: 3/34 vs UC: 2/35 EP 2: Events/patient at risk after 6 months: CR-ex: 3/34 vs UC: 2/35 EP 4: Events/patient at risk after 6 months: CR-ex: 2/34 vs UC: 2/35 EP 6: After 6 months MD 4.90, 95% CI (2.73–7.07) | |
| McKelvie et al., 2002, Canada24 | RCT | (a) EXERT (b) n = 181 (c) HFrEF, LV-EF<40% (d) NSp (e) NYHA Class II–III, 6-MWD<500 m, (f) CR-ex: 64.8 ± 1.1 vs UC: 66.1 ± 1 yrs (g) 89.5% male | (a) n = 90 (b) CR-ex (c) 3 months supervised and (d) 9 months home-based (e) 2 sessions/wk, 45–60 min (f) Aerobic exercise; 60–70% HRmax, resistance training 60% 1RM (g) 3 months out-patient, 9 months home-based | (a) n = 91 (b) UC | (a) 12 months (b) 1, 5, 6, 7 (c) adherence to exercise, 6-MWD, dynamic muscle strength, rest radionuclide ventriculography | EP 1: Events/patient at risk after 12 months: CR-ex: 9/73 vs UC: 8/83 EP 7: MLWHF 9+ months MD –0.10, 95% CI (–5.86–5.66) | |
| Giannuzzi et al., 2003, Italy25 | RCT | (a) ELVD-CHF-Trial (b) n = 90 (c) HFrEF, LV-EF<35% (d) NSp (e) NYHA class II or III, peak VO2<20 ml/kg/min, clinical stability at ≥ 3 months, optimised therapy (f) CR-ex: 60 ± 7 vs UC: 61 ± 7 yrs (g) NSp | (a) n = 45 (b) CR-ex (c) 6 months (d) Supervised 3 sessions/wk, 30 min, daily 60 min walking and calisthenics home-based (e) Aerobic exercise; 60% peak VO2 (f) Out-patient and home-based | (a) n = 45 (b) UC | (a) 6 months (b) 1, 4, 6, 7 (c) Echocardiographic results, 6-MWD | EP 1: Events/patient at risk after 6 months: CR-ex: 0/45 vs UC: 1/45 EP 2: Events/patient at risk after 6 months: CR-ex: 0/45 vs UC: 1/45 EP 4: Events/patient at risk after 6 months: CR-ex: 2/45 vs UC: 1/45 EP 6: After 6 months MD 2.50, 95% CI (1.26–3.74) | |
| Koukouvou et al., 2004, Greece26 | RCT | (a) Institutional (b) n = 29 (c) HFrEF, LV-EF<40% (d) NSp (e) NYHA class II or III (f) 52.5 ± 9.8 yrs (g) 100% male | (a) n = 16; (b) CR-ex (c) 6 months (d) 3–4 sessions/wk, 60 min (e) Aerobic exercise; 50–70% peak VO2, calisthenics, resistance training (f) Out-patient | (a) n = 10, (b) UC | (a) 6 months (b) 6, 7 (c) EPQ, BDI, HADS | EP 6: After 6 months MD 7.50, 95% CI (3.70–11.30) EP 7: MLWHF up to 6 months MD –11.10, 95% CI (–19.57– –2.63) | |
| Sabelis et al., 2004, the Netherlands27 | RCT | (a) Institutional (b) n = 29 (c) HFrEF, LV-EF<35% (d) NSp (e) NYHA class II or III, history of CHF >6 months (f) 60 ± 8 yrs (g) 100% male | (a) n = 16 (b) CR-ex (c) 6 months (d) 2 sessions/wk a 60 min supervised and 2 sessions/wk home-based (e) Aerobic IT (30/60 s); 50% of max. short-term exercise capacity, resistance training (f) Out-patient and home-based | (a) n = 13 (b) UC | (a) 6 months (b) 6 (c) Endothelial marker | EP 1: Events/patient at risk after 6 months: CR-ex: 0/16 vs UC: 0/13 EP 2: Events/patient at risk after 6 months: CR-ex: 0/16 vs UC: 0/13 EP 6: After 6 months MD 2.80, 95% CI (–0.70–6.30) | |
| Austin et al., 2005, UK28 | RCT | (a) Institutional (b) n = 200 (c) HFrEF, LV-EF < 40% (d) NSp (e) Age > 60 yrs, NYHA class II or III (f) CR-mult: 71.9 ± 6.3 vs UC: 71.8 ± 6.8 yrs (g) 66% male | (a) n = 100 (b) CR-mult (c) 8 wks CR, 16 wks community based (d) CR: 2 sessions/wk aerobic exercise, resistance training; (e) Community based 1 session/wk, 60 min; according to HF-guidelines (f) Out-patient; community based | (a) n = 100 (b) UC | (a) 6 months (b) 1, 3, 7 (c) 6-MWD, MLSQ | EP 1: Events/patient at risk after 6 months: CR-ex: 3/88 vs UC: 4/98 EP 4: Events/patient at risk after 6 months: CR-ex: 9/85 vs UC: 19/94 EP 7: MLWHF 9 + months MD –1.60, 95% CI (–10.26–7.06) | |
| Austin et al., 2008, UK29 | (a) 60 months (b) 1, 3, 7 | Long-term results of Austin et al., 200528 | |||||
| Klocek et al., 2005, Poland30 | RCT | (a) Institutional (b) n = 42 (c) HFrEF, LV-EF<40% (d) 1999–2002 (e) Age<65 yrs (f) 55.9 ± 8.1 yrs (g) 100% male | (a) n = 28; (A n = 14; B n = 14) (b) CR-ex (c) 6 months (d) 3 sessions/wk, 45 min (e) Group A: IT, 4 min, 60% HRmax and 1 min rest; Group B: progressive constant level aerobic exercise, 75% HRmax (f) Out-patient | (a) n = 14 (b) UC | (a) 6 months (b) 6 (c) Echocardiographic results PGWB; SSA-p | EP 6: After 6 months MD 3.70, 95% CI (–0.79–8.19) | |
| de Mello Franco et al., 2006, USA31 | RCT | (a) Institutional (b) n = 29 (c) HFrEF, LV-EF<40% (d) NSp (e) Aged 35–60, NYHA class II–III (f) 54.9 ± 1.9 yrs (g) 75.9% male | (a) n = 17 (b) CR-ex (c) 4 months supervised and 4 months home-based (d) 3 sessions/wk 60 min (e) 25–40 min aerobic exercise, resistance training, NSp (f) Out-patient and home-based | (a) n = 12 (b) UC | (a) 8 months (b) 6, 7 (c) FBF, muscle sympathetic nerve activity | EP 6: After 6 months MD 0.90, 95% CI (–2.44–4.24) EP 7: MLWHF up to 6 months MD –3.00, 95% CI (–18.31–12.31) | Group comparison only available for 4 months results. |
| Passino et al., 2006, Italy32 | RCT | (a) Institutional (b) n = 95 (c) HFrEF, LV-EF<40% (d) 2002–2004 (e) VO2 peak<25 ml/min/kg, clinically stable >1 month, optimal therapy (f) 60 ± 1 yrs (g) 84.2% male | (a) n = 47 (b) CR-ex (c) 9 months (d) 3 sessions/wk, 30 min (e) Aerobic exercise, 65% VO2 peak (f) Out-patient | (a) n = 12 (b) UC | (a) 9 months (b) 6, 7 (c) Echocardiographic results, BNP/NT-proBNP, neuro-hormones | EP 6: After 12–14 months MD 4.00, 95% CI (1.23–6.77) EP 7: MLWHF 9+ months MD –21.00, 95% CI (–33.55– –8.45) | |
| Mueller et al., 2007, Switzerland33 | RCT | (a) Institutional (b) n = 50 (c) HFrEF, LV-EF<40% (d) NSp (e) clinically stable >1 month (f) 55.0 ± 10 yrs (g) 100% male | (a) n = 25 (b) CR-mult (c) 1 month (d) 5 sessions/wk, 30 min; 2 sessions/day 45 min (e) Aerobic exercise, 60–80% HRR (f) In-patient | (a) n = 25 (b) UC | (a) 74 months (b) 1, 4, 6 (c) physical activity | EP 1: HR 0.8, 95% CI (0.34–1.92) EP 4: Events/patient at risk after 30+ months: CR-mult: 8/23 vs UC: 5/25 EP 6: After 6 months MD 4.20, 95% CI (1.75–6.65) | HR extracted with Tierney-tool (method 7) |
| Klecha et al., 2007, Poland34 | RCT | (a) Institutional (b) n = 50 (c) HFrEF, LV-EF < 35% (d) NSp (e) NYHA class II, III, clinically stable >6 weeks on unchanged treatment (f) 60.1 ± 9.2 yrs(g) 76% male | (a) n = 25 (b) CR-ex (c) 6 months (d) 3 sessions/wk 60 min (e) 25 min aerobic exercise, 80% HRmax, relaxation (f) Out-patient | (a) n = 25 (b) UC | (a) 6 months (b) 6 (c) MRI left ventricular evolution | EP 1: Events/patient at risk after 6 months: CR-ex: 0/25 vs UC: 0/25 EP 2: Events/patient at risk after 6 months: CR-ex: 0/25 vs UC: 0/25 EP 6: After 6 months MD 5.10, 95% CI (3.32–6.88) | |
| Dracup et al., 2007, USA35 | RCT | (a) Institutional (b) n = 173 (c) HFrEF, LV-EF < 40% (d) NSp (e) Aged 18–80 yrs NYHA class II–IV (f) 54 ± 12.5 yrs (g) 71.7% male | (a) n = 86 (b) CR-ex (c) 6 months (d) 4 sessions/wk 45 min (e) Aerobic exercise, 60% HRmax, resistance training 80% 1RM (f) Home-based | (a) n = 87 (b) UC | (a) 6 and 12 months (b) 6 months 6, 7; 12 months 3, 5 (c) 6-MWD, MAACL | EP 1: Events/patient at risk after 12 months: CR-ex: 9/87 vs UC: 8/86 EP 3: Events/patient at risk after 12 months: CR-ex: 35/87 vs UC: 37/86 EP 5: Events/patient at risk after 12 months: CR-ex: 37/87 vs UC: 38/86 EP 6: After 6 months MD 0.40, 95% CI (–0.81–1.61) EP 7: MLWHF up to 6 months MD –7.50, 95% CI (–15.12–0.12) | Combined endpoint for cardiovascular events |
| Nilson et al., 2008, Norway36 | RCT | (a) Institutional (b) n = 80 (c) HFrEF, LV-EF<40%, or ≥40 with clinical symptoms of HFpEF (d) NSp (e) Aged 18–80 yrs, NYHA class II–IIIB (f) 70.1 ± 7.9 yrs(g) 71.7% male | (a) n = 40 (b) CR-ex (c) 4 months (d) 2 sessions/wk, 50 min (e) Aerobic exercise, 60% HRmax, resistance training (f) Out-patient | (a) n = 40 (b) UC | (a) 6 and 12 months; (b) 1, 7 (c) 6-MWD | EP 1: Events/patient at risk after 6 months: CR-ex: 2/37 vs UC: 1/38 EP 7: MLWHF up to 6 months MD –5.00, 95% CI (12.57–2.57) | |
| O'Connor et al., 2009, USA37 | RCT | (a) HF-ACTION trial (b) n = 2331 (c) HFrEF, LV-EF≤35% (d) 2003–2007 (e) NYHA class II to IV, >6 wks optimal HF-treatment (f) 59 yrs (g) 72% male | (a) n = 1159 (b) CR-ex (c) Supervised 3 months; home-based 9–10.5 months (d) 3 sessions/wk 15–35 min; 5 sessions/wk, 40 min (e) Aerobic exercise, 60–70% HRR (f) Out-patient, home-based | (a) n = 1172 (b) UC | (a) Median 30 months (b) 1, 2, 5, 6 | EP 1: HR 0.96, 95% CI (0.79–1.17) EP 2: HR 0.92, 95% CI (0.74–1.15) EP 3: Events/patient at risk after 30 months: CR-ex: 729/1159 vs UC: 760/1171 EP 5: HR 0.93, 95% CI (0.85–1.02) EP 6: After 12–14 months MD 0.60, 95% CI (0.34–0.86) EP 7: KCCQ up to 6 months MD 1.93, 95% CI (0.85–3.01) | Combined endpoint for cardiovascular events Sample sizes for peak oxygen consumption was derived by overall sample size divided by 2. |
| Flynn et al., 2009, USA38 | RCT | (a) HF-ACTION trial (see O'Connor et al., 2009)37 | (a) 3, 6, 9, 12, months then annually for 4 yrs, median 2.5 yrs (b) 7 | HF-ACTION trial (see O'Connor et al., 2009)37 | |||
| Jolly et al., 2009, UK39 | RCT | (a) BRUM-CHF-study (b) n = 169 (c) HFrEF, LV-EF≤40% (d) 2004–2005 (e) ≥NYHA class II, >4 wks clinically stable with optimal therapy (f) CR-ex: 65.9 ± 12.5 vs UC: 70 ± 12.5 yrs (g) 74.6% male | (a) n = 84; (b) CR-ex (c) 3 supervised sessions (d) 6 months home-based with telephone support (e) 5 sessions/wk, 20–30 min (f) Aerobic exercise, 70% VO2 peak, resistance training (g) Home-based | (a) n = 85 (b) UC | (a) 12 months (b) 1, 3, 4, 5, 7 (c) EQ-5D-5L, HADS, physical activity score, ISWT | EP 1: Events/patient at risk after 12 months: CR-ex: 7/84 vs UC: 5/85 EP 3: Events/patient at risk after 12 months: CR-ex: 16/84 vs UC: 20/85 EP 4: Events/patient at risk after 12 months: CR-ex: 4/84 vs UC: 2/85 EP 5: HR 1.45, 95% CI (0.43–4.86) EP 7: MLWHF 9+ months MD 2.76, 95% CI (–4.47–9.87) | Combined endpoint for cardiovascular events |
| Belardinelli et al., 2012, Italy40 | RCT | (a) Institutional (b) n = 123 (c) HFrEF, LV-EF≤40% (d) NSp (e) ≥3 months clinically stable (f) 59 ± 14 yrs (g) 78% male | (a) n = 63 (b) CR-ex (c) 120 months (d) 3 months 3 session/wk; 117 months 2 sessions/wk, 60 min (e) Aerobic exercise, 70% VO2 peak (f) Out-patient | (a) n = 60 (b) UC | (a) 120 months, evaluation every 12 months (b) 1, 2, 3, 6, 7 (c) Echocardiographic results | EP 1: HR 0.68, 95% CI (0.30–1.54) EP 2: Events/patient at risk after 120 months: CR-ex: 4/63 vs UC: 10/60 All death were cardiac nature (see EP 1) EP 3: HR 0.64, 95% CI (0.34–0.81) EP 4: Events/patient at risk after 30+ months: CR-ex: 8/63 vs UC: 10/60 EP 6: after 12–14 months MD 3.40, 95% CI (1.15–5.65) | |
| Norman et al., 2012, Netherlands41 | RCT | (a) Institutional (b) n = 42 (c) HFrEF, LV-EF≤40% (d) NSp (e) Aged≥21 yrs, NYHA class II–IV, >30 days clinically stable with optimal therapy (f) CR-ex: 56.0 ± 2.7 vs UC: 63.0 ± 3.4 yrs (g) 54.8% male | (a) n = 22; (b) CR-ex (c) 3 wk (d) 3 wk, 3 sessions/wk, 60 min, (e) Aerobic exercise, 40–60% HRR, resistance training (f) Out-patient | (a) n = 20 (b) UC (Attention-UC) | (a) 6 months (b) 7 (c) BNP, 6-MWD | EP 1: Events/patient at risk after 6 months: CR-ex: 1/21 vs UC: 0/20 EP 2: Events/patient at risk after 6 months: CR-ex: 0/21 vs UC: 0/20 EP 7: KCCQ up to 6 months MD 3.10.95% CI (–6.68–12.88) | |
| de Meirelles et al., 2014, Brasil42 | RCT | (a) Institutional (b) n = 30 (c) HFrEF, LV-EF≤40% (d) NSp (e) ≥3 months clinically stable, exercise capacity ≥3 METs (f) CR ex 54 ± 3 vs UC 55 ± 2 yrs (g) 46.7% male | (a) n = 15, (b) CR-ex (c) 6 months (d) 3 sessions/wk, >30 min (e) 30 min aerobic exercise, 15% >VAT, resistance training 3 sets 10–15 reps (f) Out-patient | (a) n = 15 (b) UC | (a) 6 months (b) 6 (c) Inflammatory markers, biomarkers of oxidative stress platelet aggregation | EP 6: After 6 months MD 5.50, 95% CI (4.93–6.07) | |
| Dehkordi et al., 2015, Iran43 | RCT | (a) Institutional (b) n = 66 (c) HFrEF, LV-EF ≤ 40% (d) NSp (e) Optimal therapy (f) 65 ± 15 yrs (g) 62% male | (a) n = 33 (b) CR-ex (c) 6 months (d) 3 sessions/wk, 40 min (e) Aerobic, walking 70% HRR (f) Out-patient | (a) n = 33 (b) UC with educational support | (a) 6 months (b) 7 (c) Echocardiographic results | EP 7: After 6 months CR-ex: 61.01 ± 14.9 to 63.34 ± 12.69 vs UC: 62.34 ± 11.25 to 58.43 ± 8.67 | MacNew Heart Disease Health-related Quality of Life questionnaire |
| Höllriegel R et al., 2016, Germany44 | RCT | (a) Institutional (b) n = 37 (c) HFrEF, LV-EF<30% (d) NSp (e) NYHA class IIIb, clinically stable >2 months, optimal therapy (f) 60 ± 3 yrs (g) 100% male | (a) n = 18 (b) CR-ex (c) 12 months (d) 3 wks: 3–6 sessions daily, 5–20 min; 12 month: daily 20–30 min home-based and one supervised session at 60 min weekly (e) Aerobic exercise training (cycle ergometer) 50–60% maximal exercise capacity (f) In-patient and home-based | (c) n = 19 (a) UC | (d) 12 months (e) 1, 2, 3, 4, 6 (f) Echocardiographic results | EP 1: Events/patient at risk after 12 months: CR-ex 0/15 vs UC: 1/9 EP 2: Events/patient at risk after 12 months: CR-ex 0/15 vs UC: 1/9 EP 3: Total number of observed events: CR-ex: 7 vs UC: 7 EP 4: Total number of observed events: CR-ex: 3 vs UC: 5 EP 6: after 12 months MD 4.60, 95% CI (2.22–6.98) | |
| Ellingsen et al., 2017, Europe45 | RCT | (a) SMARTEX heart failure study (b) n = 261 (c) HFrEF, LV-EF ≤ 35% (d) 2009–2014 (e) NYHA class II–III, optimal therapy (f) Median 60 yrs; CR-ex: 78, 54 ± 3 vs UC: 55 ± 2 yrs (g) 81% male | (a) n = 78 (b) CR-ex (c) 3 months (d) 3 sessions/wk, 47 min (e) Moderate continues aerobic exercise*, 60–70% HRmax (f) Out-patient | (a) n = 81, (b) UC advised to physical activity (c) HIIT n = 88* | (a) 12 months (b) 1, 2, 3, 4, 6, 7 (c) Echocardiographic results, IPAQ 7 short form, HADS | EP 1: Events/patient at risk after 12 months: CR-ex: 3/73 vs UC: 1/76 EP 2: Events/patient at risk after 12 months: CR-ex: 1/73 vs UC: 0/76 EP 3: Events/patient at risk after 12 months: CR-ex: 16/73 vs UC: 38/76 EP 4: Events/patient at risk after 12 months: CR-ex: 6/73 vs UC: 15/76 EP 6: After 12–14 months MD –1.80, 95% CI (–4.56–0.96) EP 7: KCCQ 9+ months MD –2.00, 95% CI (–11.93–7.93) | Two* intervention groups (only the moderate continuous training group used) |
| Dalal et al., 2018, UK46 | RCT | (a) REACH-HF (b) n = 216 (c) HFrEF, LV-EF≤40% (d) NSp (e) Confirmed diagnosis of HFrEF, aged≥18 yrs (f) CR-ex: 69.7 ± 10.9 vs UC: 69.9 ± 11 (g) 78% male | (a) n = 107 (b) CR-mult (c) 12 weeks (d) 3 sessions/wk (e) Structured exercise programme with chair-based exercise and a progressive walking programme (f) Home-based comprehensive self- management CR with regular telephone contacts | (a) n = 109 (b) UC | (a) 12 months (b) 1, 2, 3, 4, 7 (c) EQ-5D, Heart QoL, HADS, SCHFI, NT-proBNP, costs | EP 1: Events/patient at risk after 12 months: CR-ex: 4/96 vs UC: 4/97 EP 2: Events/patient at risk after 12 months: CR-ex: 1/96 vs UC: 4/97 EP 3: Events/patient at risk after 12 months: CR-ex: 19/107 vs UC: 24/109; OR 0.80 95% CI (0.47–1.36) EP 4; CR-ex: 3/107 vs UC: 6/109; OR 0.51 95% CI (0.13–196) EP 7: MLWHF after 12 months MD –3.40, 95% CI (–10.51–2.12) | |
| Lang et al., 2018, UK47 | (a) REACH-HF (b) n = 50 (c) HFpEF, LV-EF≥45% (d) NSp (e) Confirmed HFpEF-diagnosis within the last 6 months (f) 73.9 yrs (g) 56% male | (a) n = 25 (b) CR-mult (c) 12 weeks (d) 3 sessions/wk (e) Structured exercise programme with chair-based exercise and a progressive walking programme (f) Home-based comprehensive self- management CR with regular telephone contacts | (a) n = 25 (b) UC | (a) 6 months (b) 3, 4, 7 (c) Heart QoL, ISWT, HADS, SCHFI, EQ-5D-5L | EP 3: Events/patient at risk after 6 months: CR-mult: 4/25 vs UC: 7/25 EP 4: Events/patient at risk after 6 months: CR-mult: 0/25 vs UC: 4/25 EP 7: MLWHF after 6 months final values: MD –9.5 95% CI (–25.86–6.86), change score: MD –11.5, 95% CI (–22.8–0.3) | HFpEF –patients only |
1RM: one repetition maximum; 6-MWD: 6-minute-walking distance; BDI: Beck Depression Inventory Questionnaire; BNP: B-type naturetic peptide; BRUM-CHF-study: Birmingham Rehabilitation Uptake Maximization study for patients with Congestive Heart Failure; CHF: chronic heart failure; CI: confidence interval; CR: cardiac rehabilitation; CR-ex: cardiac rehabilitation including exercise only; CR-mult: multicomponent cardiac rehabilitation including exercise; CROS-HF: Cardiac Rehabilitation Outcome Study in Heart Failure; CV: cardiovascular; ELVD-CHF-Trial: Exercise in Left Ventricular Dysfunction and Chronic Heart Failure Trial; EP: endpoint; EPQ: Eysenck Personality Questionnaire; EQ-5D-5L: Five-Level-EuroQol-Five-Dimentional-Questionnaire; EXERT: the Exercise Rehabilitation Trial; FBF: forearm blood flow; HADS: Hospital Anxiety and Depression Scale; HF: heart failure; HF-ACTION: a controlled trial investigating outcomes of exercise training; HFprEF: heart failure with preserved left ventricular ejection fraction; HFrEF: heart failure with reduced left ventricular ejection fraction; HR: hazard ratio; HRmax: maximal heart rate; HIIT: high intensity interval training; HRR: heart rate reserve; IPAQ: International Physical Activity Questionnaire; ISWT: Shuttle Walk Test; IT: interval training; KCCQ: Kansas City Cardiomyopathy Questionnaire; LVEF: left ventricular ejection fraction; MAACL: Multiple Affect Adjective Checklist; max: maximum; MD: mean difference; MET: metabolic equivalent; min: minutes; MLWHF: Minnesota Living with Heart Failure Questionnaire; MLSQ: Modified Linkert Symptom Questionnaire; MRI: magnetic resonance imaging; n: number; NSp: not specified; NYHA: New York Heart Association; PGWB: Psychological Well-being Index; proBNP: pro-brain natriuretic peptide; PWC: physical work capacity; QoL: Quality of Life; RCT: randomised controlled trial; REACH-HF: Rehabilitation EnAblement in CHronicHeart Failure; reps: repetitions; sd: standard deviation; SCHFI: Self-Care of Heart Failure Index; SSA-p: Subjective Symptoms Assessment profile; UC: usual care; VAT: ventilatory threshold; VO2: oxygen capacity; wk: week; yrs: years.