Can Exercise Training Enhance the Functional Capacity and Diastolic Function in Heart Failure With Preserved Ejection Fraction? A Systematic Review and Meta-analysis in the East Asian Population.

BACKGROUND AND OBJECTIVES: Recent research indicated that the physiological mechanisms in heart failure with preserved ejection fraction (HFpEF) patients across various ethnicities/races exhibited distinct findings. Published research predominantly derives from Western populations and lacks evidence concerning the effects of exercise training on East Asian individuals. This study aimed to examine the impact of exercise training interventions on peak oxygen consumption (VO2) and diastolic function in the East Asian population with HFpEF. METHODS: Articles were retrieved utilizing Medical Subject Headings phrases across 3 databases. Our research, documented in the PROSPERO database, encompassed trials and prospective studies that investigated peak VO2 and diastolic function in East Asian patients with HFpEF who participated in an exercise training program. The random-effects model was utilized to evaluate the aggregated effect, represented as a mean difference (MD). The leave-one-out strategy was utilized to exclude research to evaluate the robustness of the results. RESULTS: Six studies were examined; however, only 4 were appropriate for quantitative analysis. Exercise training for HFpEF patients successfully elevated the average peak VO2 (MD, 1.99; 95% confidence interval [CI], 0.57, 3.40; p=0.006; I2=57%). However, there was no alteration in diastolic function (E/A [MD, -0.17; 95% CI, -0.57, 0.23; p=0.41; I2=89%] and E/e' [MD, -0.92; 95% CI, -3.58, 1.75; p=0.50; I2=43%]) after exercise intervention. CONCLUSIONS: Exercise training for a minimum of 12 weeks, irrespective of the exercise modality, is associated with improvements in exercise capacity among the selected East Asian patients, particularly in peak VO2, while observing minimal influence on diastolic function. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) Identifier: CRD420251040914.