Safety and efficacy of exercise training in elderly heart failure patients: a systematic review and meta-analysis

It is unclear whether exercise training is effective and safe for elderly patients with chronic heart failure (CHF). The purpose of this meta-analysis was to systematically analyse the completed trials assessing the safety and efficacy of exercise training in elderly patients with heart failure.

We searched electronic databases up to September 2012 for randomised controlled trials (RCTs) evaluating exercise training in the elderly heart failure patients (≥ 60 years). The safety and efficacy of exercise training were assessed by all-cause mortality, hospitalisations, 6-min walking distance (6MWD), peakVO2 and/or health-related quality of life (HRQoL).

Seven prospective RCTs were included with a total of 530 patients, and the patients' mean age ranged from 70 to 81 years. The majority were male, low-to-medium risk and New York Heart Association class II and III with a left ventricular ejection fraction of < 45%. Exercise training increased the 6MWD significantly by 50.05 m (95% CI: 28.37-71.73) and improved generic HRQoL (95% CI: 0.06-0.18). There was no significant difference in mortality, hospitalisations, peakVO2 and disease-specific HRQoL between exercise group and control group.

In elderly CHF patients (mean age 70-81), exercise training increase 6MWD and improve generic HRQoL, but has no effects on mortality, hospitalisations, peakVO2 and disease-specific HRQoL. The long-term efficacy and safety of exercise training in elderly heart failure patients require further study based on large and rational-designed controlled clinical trials.