Comparative Analysis of the Effectiveness of Cardiovascular Rehabilitation in Patients with Heart Failure: Systematic Review and Bayesian Network Meta-Analysis

• Grant number: 25/01092-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: April 01, 2025
• End date: March 31, 2026
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Francis Lopes Pacagnelli
• Grantee: Milene Vitoria Sampaio Sobral
• Host Institution: Pró-Reitoria de Pesquisa e Pós-Graduação. Universidade do Oeste Paulista (UNOESTE). Presidente Prudente , SP, Brazil

Abstract

Heart failure (HF) is a complex clinical condition affecting millions of people worldwide, leading to high morbidity and mortality and imposing a significant burden on healthcare systems. Exercise-based cardiac rehabilitation (EBCR) has shown benefits in terms of functional capacity and quality of life; however, there remains uncertainty regarding its comparative efficacy in reducing major cardiovascular events and mortality. Thus, research is needed to provide robust evidence to guide clinical practice, support guidelines, and inform cardiac rehabilitation programs. This systematic review and network meta-analysis aims to evaluate the comparative efficacy of different exercise-based cardiac rehabilitation interventions in reducing major cardiovascular events and mortality in patients with heart failure. The systematic review will be conducted and reported according to the guidelines of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). A systematic search will be performed in PubMed (Medline), Embase, and Cochrane databases up to March 2025, including randomized clinical trials (RCTs) that compare at least two exercise-based cardiac rehabilitation interventions in patients with HF. The primary outcome of interest will be the incidence of major adverse cardiovascular events (myocardial infarction, stroke, and cardiovascular mortality). The efficacy of the interventions will also be assessed based on HF classification according to ejection fraction. After article selection and data extraction, the data will undergo bias analysis and meta-analysis. This study aims to determine the comparative efficacy of different EBCR interventions in patients with HF.