Resistance exercise enhances oxygen uptake without worsening cardiac function in patients with systolic heart failure: a systematic review and meta-analysis

Recent literature suggests that resistance training (RT) improves peak oxygen uptake (( dot{mathrm{V}}{mathrm{O}}_2 ) peak), similarly to aerobic exercise (AE) in patients with heart failure (HF), but its effect on cardiac remodeling is controversial. Thus, we examined the effects of RT and AE on ( dot{mathrm{V}}{mathrm{O}}_2 ) peak and cardiac remodeling in patients with heart failure (HF) via a systematic review and meta-analysis. MEDLINE, EMBASE, Cochrane Library and CINAHL, AMEDEO and PEDro databases search were extracted study characteristics, exercise type, and ventricular outcomes. The main outcomes were ( dot{mathrm{V}}{mathrm{O}}_2 ) peak (ml kg^?1 min^?1), LVEF (%) and LVEDV (mL). Fifty-nine RCTs were included. RT produced a greater increase in ( dot{mathrm{V}}{mathrm{O}}_2 ) peak (3.57 ml kg^?1 min^?1, P < 0.00001, I ² = 0%) compared to AE (2.63 ml kg^?1 min^?1, P < 0.00001, I ² = 58%) while combined RT and AE produced a 2.48 ml kg^?1 min^?1 increase in ( dot{mathrm{V}}{mathrm{O}}_2 ); I ² = 69%) compared to control group. Comparison among the three forms of exercise revealed similar effects on ( dot{mathrm{V}}{mathrm{O}}_2 ) peak (P = 0.84 and 1.00, respectively; I ² = 0%). AE was associated with a greater gain in LVEF (3.15%; P < 0.00001, I ² = 17%) compared to RT alone or combined exercise which produced similar gains compared to control groups. Subgroup analysis revealed that AE reduced LVEDV (? 10.21 ml; P = 0.007, I ² = 0%), while RT and combined RT and AE had no effect on LVEDV compared with control participants. RT results in a greater gain in ( dot{mathrm{V}}{mathrm{O}}_2 ) peak, and induces no deleterious effects on cardiac function in HF patients.