Effects of physical exercise on health-related quality of life in coronary heart disease patients. a systematic review and meta-analysis

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): - HEARTY-BRAIN - Effects of Exercise on Brain in Patients with Coronary Heart Disease: The Heart-Brain Connection. Andalusian Plan for Research Development and Innovation (PAIDI). University of Granada. Funding: 116.000 €. PI: F. Ortega. 2021-2021. - VASCULACTIVE. Effects of exercise on brain vascularization in coronary heart disease patients. Spanish Ministry of Economy and Competitiveness (I+D+I RETOS). University of Granada. Funding: 121.000 €. PI: F. Ortega. 2021-2023. Background Coronary heart disease (CHD) is the most prevalent type of cardiovascular disease in the world, and a leading cause of mortality and morbidity. Previous research showed that patients with CHD have a decrease in health-related quality of life (HRQoL) during the course of the disease. Physical exercise may attenuate the decline in HRQoL observed in CHD patients. Purpose To determine the effect of exercise training interventions on HRQoL in CHD patients. Methods A systematic search of controlled trials (CTs) assessing the effects of exercise training on HRQoL in CHD patients was performed in Web of Science, PubMed, Scopus, EMBASE, Cochrane Register, SportDiscus, PsycINFO and Google Scholar from inception to 30 June 2022. A meta-analysis with fixed and random effects was performed on controlled trials (comparing at least one exercise group with one non-exercise group and including a global score of HRQoL assessments before and after the interventions. All statistical analyses were performed using R-Studio. Results A total of 26 CTs met all the eligibility criteria and were included in the review (25 randomized CTs and 1 non-randomized CTs). HRQoL was mostly assessed by the SF-36 instrument (11/26) and the MacNew Heart Disease Health-Related Quality of Life questionnaire (8/26). Six out of the 26 studies reported the total score of quality of life and were included in the meta-analysis, which resulted in 8 exercise interventions and 591 participants with a mean age of 61 years, and 33% was women. There was a small (effect size 0.20) borderline overall effect of exercise on HRQoL in CHD patients (95% confidence interval: fixed effect, 0.05–0.36; random effect, -0.06-0.46. The percentage of total variability attributed to between-study heterogeneity [I2] = 44%, P=0.09 (Figure 1). Conclusions Findings from this meta-analysis suggest that supervised exercise training may cause a modest improvement in HRQoL in CHD patients. Future studies should explore which type and loads of exercise lead to larger improvements.