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. 2022 Sep 20:9:961414.
doi: 10.3389/fcvm.2022.961414. eCollection 2022.

Effects of high-intensity and moderate-intensity exercise training on cardiopulmonary function in patients with coronary artery disease: A meta-analysis

Liying Zheng  1 , Deng Pan  1   2 , Yimeng Gu  1 , Rumeng Wang  1 , Yanyan Wu  1   2 , Mei Xue  1
Affiliations

Effects of high-intensity and moderate-intensity exercise training on cardiopulmonary function in patients with coronary artery disease: A meta-analysis

Liying Zheng et al. Front Cardiovasc Med. .

Abstract

Purpose: The study aims to evaluate the effects of high-intensity and moderate-intensity exercise training on cardiopulmonary function and exercise endurance in patients with coronary artery diseases (CAD).

Methods: We performed a systematic search of the English and Chinese databases from their inception to March 2022. Randomized controlled trials (RCTs) were included to compare high-intensity and moderate-intensity exercise training on cardiopulmonary function in patients with CAD. The primary outcomes included peak oxygen uptake (peak VO2) and anaerobic threshold (AT). The secondary outcomes included left ventricular ejection fraction (LVEF), exercises duration (ED), respiratory exchange ratio (RER), resting heart rate (RHR), peak heart rate (PHR) and oxygen pulse (O2 pulse). The continuous variables were expressed as mean differences (MD) along with their corresponding standard deviations (SD), and the I2 test was applied in the assessment of heterogeneity.

Results: After systematically literature search, 19 studies were finally selected for our meta-analysis (n = 1,036), with 511 patients in the experimental group (high-intensity exercise) and 525 patients in the control group (moderate-intensity exercise). The results showed that high-intensity exercise significantly increased patients' Peak VO2 [MD = 2.67, 95% CI (2.24, 3.09), P < 0.00001], LVEF [MD = 3.60, 95% CI (2.17, 5.03), P < 0.00001], ED [MD = 37.51, 95% CI (34.02, 41.00), P < 0.00001], PHR [MD = 6.86, 95% CI (4.49, 9.24), P < 0.00001], and O2 pulse [MD = 0.97, 95% CI (0.34, 1.60), P = 0.003] compared with moderate-intensity exercise. However, there were no significant differences in AT [MD = 0.49, 95% CI (-0.12, 1.10), P = 0.11], RER [MD = 0.00, 95% CI (-0.01, 0.02), P = 0.56], and RHR [MD = 1.10, 95% CI (-0.43, 2.63), P = 0.16].

Conclusion: Our results show that high-intensity exercise training has more significant positive effects compared with moderate-intensity exercise training in improving peak VO2, LVEF, ED, PHR and O2 pulse in patients with CAD, while no significant differences were observed in AT, RER and RHR. To sum up, high-intensity exercise training is better than moderate-intensity exercise training in improving cardiopulmonary function and exercise endurance in patients with CAD.

Systematic review registration: PROSPERO (CRD42022328475), https://www.crd.york.ac.uk/PROSPERO/.

Keywords: anaerobic threshold; coronary artery disease; exercise intensity; meta-analysis; peak oxygen uptake.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of literature search and selection process.
Figure 2
Figure 2
(A) Overall analysis diagram. (B) Single literature analysis diagram. “+” is low risk. “?” is unclear, and “–” is high risk.
Figure 3
Figure 3
Forest plot comparing the improvement of peak VO2 between two exercise intensity.
Figure 4
Figure 4
Forest plot comparing the improvement of AT between two exercise modes.
Figure 5
Figure 5
Forest plot of the effects of high-intensity and moderate-intensity exercise on LVEF in CAD patients.
Figure 6
Figure 6
Forest plot comparing the effects of two exercise modes on ED improvement.
Figure 7
Figure 7
Forest plot comparing the effects of two exercise modes on RER improvement.
Figure 8
Figure 8
Forest plot of the effects of high-intensity and moderate-intensity exercise on RHR in CAD patients.
Figure 9
Figure 9
(A) Forest plot of the effects of high-intensity and moderate-intensity exercise on PHR in CAD patients. (B) Forest plot comparing the improvement effect of two exercise modes on O2 pulse.
Figure 10
Figure 10
(A) Subgroup analysis of peak VO2. (B) Subgroup analysis of RER. (C) Subgroup analysis of PHR.
Figure 11
Figure 11
(A) Subgroup analysis of ED. (B) Subgroup analysis of RHR.
Figure 12
Figure 12
Funnel chart of publication bias.
See this image and copyright information in PMC

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