Abstract
Heart Failure (HF) is associated with significantly high morbidity and mortality. We performed a meta-analysis and updated new evidences from randomized controlled trials (RCTs) to determine the effects of Tai Chi (TC) in patients with HF. Electronic literature search of Medline, PubMed, EMBASE, the Cochrane Library, China national knowledge infrastructure (CNKI), and Wan Fang Database was conducted from inception of their establishment until 2017. And we also searched Clinical Trials Registries (https://clinicaltrials.gov/ and www.controlled-trials.com) for on-going studies. A total of 11 trials with 656 patients were available for analysis. The results suggested that TC was associated with an obviously improved 6-min walk distance [6MWD, weighted mean difference (WMD) 65.29 m; 95% CI 32.55–98.04] and quality of life (Qol, WMD −11.52 points; 95% CI −16.5 to −6.98) and left ventricular ejection fraction (LVEF, WMD 9.94%; 95% CI 6.95 to 12.93). TC was shown to reduce serum B-type natriuretic peptide [BNP, standard mean difference (SMD) −1.08 pg/mL; 95% CI −1.91 to −0.26] and heart rate (HR, WMD −2.52 bpm; 95% CI −3.49 to −1.55). In summary, our meta-analysis demonstrated the clinical evidence about TC for HF is inconclusive. TC could improve 6MWD, Qol and LVEF in patients with HF and may reduce BNP and HR. However, there is a lack of evidence to support TC altering other important long-term clinical outcomes so far. Further larger and more sustainable RCTs are urgently needed to investigate the effects of TC.
Highlights
Heart Failure (HF) is a major public health concern with a serious of clinical symptoms, due to any structural or functional damage of ventricular filling or blood ejection
Our result showed that Tai Chi (TC) can significantly improve 6-min walk distance (6MWD) compared with the control group
Walking was a daily activity performed but the most serious patients. This measures the distance that a patient could quickly walk on a flat, hard surface for a period of 6 min. We chose this outcome as a common primary outcome measure; the 6MWD evaluated responses of all the systems involved during exercise, including respiratory system, circulatory system, and motor nervous system
Summary
Heart Failure (HF) is a major public health concern with a serious of clinical symptoms, due to any structural or functional damage of ventricular filling or blood ejection. Effects of TaiJi on HF new HF cases annually (Benjamin et al, 2017). It was associated with significantly high morbidity and mortality, which remained about 50% within 5 years (Ponikowski et al, 2016). In China, the prevalence rate of HF was approximately 0.9% in 2003 (Zhou et al, 2015) According to this estimate, there were about 4 million cases of heart failure patients in 2015 (Zhou et al, 2015). Pharmacologic therapies were often used as the most common methods of symptom palliation, medications were generally not insufficient to completely relieve symptoms, and some medications may be contraindicated in HF (Kwekkeboom and Bratzke, 2016)
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