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This study aimed to examine the effectiveness of high-intensity interval training (HIIT) on pulmonary function and exercise capacity in individuals with chronic obstructive pulmonary disease (COPD). Ten databases (PubMed, the Cochrane Library, Web of Science, EMBASE, MEDLINE, CINAHL, CNKI, Wanfang, Weipu, and CBM) were searched for relevant articles published from inception to 30 June 2020. Studies were included if they were randomized controlled trials (RCTs) comparing a HIIT group with usual care or other training groups. Quality was assessed using the Physiotherapy Evidence Database (PEDro) scale, and the overall quality of evidence was assessed using the GRADE approach. The primary outcomes were peak VO2 and FEV1% predicted, and the secondary outcomes were FEV1/FVC, peak VE, peak WR, 6MWD, dyspnea, health-related quality of life, and adverse event. Twelve articles (689 patients) were included. HIIT was shown to have a positive effect on exercise capacity (peak WR, 6MWD), pulmonary function (FEV1% pred, peak VE), dyspnea, and quality of life. However, sensitivity analyses for dyspnea were unstable, and the result changed from positive to negative after removing one study (SMD = − 0.13, 95% CI [− 0.44, 0.17], P = 0.40). HIIT could improve pulmonary function, exercise capacity, and quality of life but may not decrease dyspnea in patients with COPD. It can be recommended as a safe and effective exercise modality in rehabilitation programs. Given that the overall results were based on a limited number of studies with significant heterogeneity and some of the results were based on low GRADE rating evidence, more high-quality, larger sample size, multicenter, and long-term follow-up RCTs are needed to confirm the clinical efficacy of HIIT in patients with COPD. CRD42020165897.

Objective: To assess the effectiveness of tele-monitored cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation. Design: Single-centre, prospective, assessment-blinded, randomised controlled trial. Setting: Domiciliary rehabilitation with support from a tertiary care hospital. Subjects: One hundred patients who underwent ablation for atrial fibrillation were recruited. Interventions: Participants were randomly allocated to a 12-week standard rehabilitation treatment (control group) or a comprehensive, domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program (intervention group) in a 1:1 fashion. Main outcome measures: The primary endpoint was the improvement in VO2peak. The secondary outcomes included adherence, physical activity, beliefs related to cardiovascular disease and exercise self-efficacy. Results: Ninety-seven patients completed follow-up. The mean VO2peak increased significantly in both the intervention group ( n = 49) (baseline vs 12 weeks: 19.1 ± 4.7 vs 27.3 ± 5.6 ml/(min kg), P Conclusions: Our domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program could lead to a more significant improvements in physical fitness, adherence and health beliefs than standard cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation.

Aim To evaluate whether high‐intensity interval training (HIIT) was superior to low‐intensity training or usual care among patients after percutaneous coronary intervention. The hypothesis was that HIIT would help patients after percutaneous coronary intervention (PCI) improve cardiopulmonary function, lipid profiles and in‐stent restenosis. Design A systematic review and meta‐analysis were conducted according to the Preferred Reporting Items for Systematic Review and Meta‐analysis (PRISMA)2009 Checklist. Methods Randomized controlled trials (RCTs) focusing on HIIT programme in patients after PCI were searched in Cochrane Library, Web of Science Core Collection, EMbase, PubMed, China National Knowledge Infrastructure (CNKI) and SinoMed from the inception to 24 March 2020. Standard Mean difference (SMD) and 95% confidence intervals (CI) were performed to summarize the effect sizes. Results Six RCTs (247 patients) met the criteria. HIIT programme had a statistically significant effect on raising left ventricular ejection function (LVEF) (SMD = 0.38, 95%CI [0.03, 0.73], I 2 = 3%), VO2peak (SMD = 0.94, 95%CI [0.61, 1.28], I 2 = 0%), as well as improving the serum level of high‐density lipoprotein (SMD = 0.55, 95%CI [0.06, 1.03], I 2 = 0%) and late luminal loss (SMD = −0.65, 95%CI [−1.07, −0.23], I 2 = 0%). But HIIT had no prominent effect on improving heart rate (SMD = −0.04, 95%CI [−0.29, 0.21], I 2 = 0%). Summarily, HIIT programme appears to be favourable for CAD patients after PCI by improving cardiopulmonary function, such as LVEF and VO2peak, as well as reducing late luminal loss in per stented arteries. Nevertheless, HIIT has no advantage for adjusting heart rate. More researches with rigorous methods are warranted to explore the controversy about lipid profiles.

IntroductionHeart failure (HF) is an end-stage of numerous heart diseases including hypertension, coronary heart disease and arrhythmia, in which the heart is unable to perform its circulatory function with sufficient efficiency due to structural or functional dysfunction (systolic or diastolic alterations). Strategies such as exercise rehabilitation may improve cardiac function, exercise capacity and health-related quality of life and reduce anxiety and depression in patients with HF. However, the relative effectiveness as well as the hierarchy of exercise interventions have not been well established, although various exercise options are available. Therefore, this protocol proposes to conduct a network meta-analysis (NMA) aiming to compare the effectiveness of different types of exercise training in patients with HF.Methods and analysisPubMed, Embase and the Cochrane Library will be searched from inception to March 2021 for relevant randomised controlled trials. Other resources, such as Google Scholar and Clinical Trials.gov will also be considered. Studies assessing exercise rehabilitation in patients with HF will be selected. Two independent reviewers will identify eligible trials. The PEDro risk of bias assessment tool will be used to assess the quality of the included studies. Bayesian NMA will be used when possible to determine the comparative effectiveness of the different exercise interventions. The mean ranks and surface will estimate the ranking probabilities for the optimal intervention of various treatments under the cumulative ranking curve. Subgroup, sensitivity and meta-regression will be conducted to explain the included studies’ heterogeneity if possible. We will also use the Grading of Recommendations, Assessment, Development, and Evaluation system to assess the strength of evidence.Ethics and disseminationThis systematic review and NMA will synthesise evidence on the effectiveness of the different exercises in patients with HF. The results will be submitted to a peer-reviewed journal. No ethical approval will be required because the data used for the review will be exclusively extracted from published studies.PROSPERO registration numberCRD42020165870.

BackgroundHigh-intensity interval training, for its characteristic of short-time high oxygen-consumption exercise interphase with periods of low-intensity training or rest for recovery, is easier to persist and execute in cardiac rehabilitation. However, it is little known whether HIIT program has an advantageous effect on patients after percutaneous coronary intervention or not.MethodsRandomized controlled trials (RCTs) focusing on HIIT program in patients after PCI were searched in Cochrane Library, Web of Science Core Collection, EMbase, PubMed, China National Knowledge Infrastructure (CNKI) and SinoMed from the inception to March 24, 2020. Two reviewers conducted the literature retrieval, data extraction, and quality assessment independently. Standard Mean difference (SMD) and 95% confidence intervals (CI) were performed to summarize the effect sizes.Results6 RCTs (247 patients) met the criteria. HIIT program had a statistically significant effect on raising left ventricular ejection function (LVEF) (SMD=0.38, 95%CI[0.03, 0.73], p=0.03), VO2peak (SMD=0.94, 95%CI[0.61, 1.28], pConclusionsHIIT program might be favorable for CAD patients after PCI by improving cardiopulmonary function, such as LVEF and VO2peak, as well as reducing late luminal loss in per stented arteries. Nevertheless, HIIT had no advantage for adjusting heart rate. More researches with rigorous methods are warranted to explore the controversy about lipid profiles.

This study aimed to systematically evaluate the effect of nursing interventions on reducing dietary sodium intake in patients with chronic heart failure, further to provide insight on the most utilized nursing practices. Only randomized controlled trials on dietary sodium management of nursing interventions were collected from Pubmed, CINAHL, Web of Science, Embase and The Cochrane Library (CENTRAL). Among 515 available studies, a total of 8 ones met the inclusion criteria and were included. The meta-analysis result suggested that nursing interventions could reduce dietary sodium intake in patients with chronic heart failure within 6 months compared with conventional care [SMD (-0.305, 95%CI -0.561, -0.049)]. Considering the sodium levels estimated by the 3-day food record is much lower than those by the 24-hour urinary sodium, it is better to analyze separately to further clarify the effect of nursing interventions. Hence, further meta-analysis results showed that the sodium intake estimated by the 3-day diet record/diary in the experimental group was lower than that in the control group [SMD -0.523, 95%CI (-0.894 to -0.152), P=0.006]. Similarly, the sodium intake in the experimental group was lower than that in the control group by 24-hour urine specimen [WMD -364.318, 95% CI (-603.953 to -124.684), P=0.003]. We concluded that nursing interventions can reduce dietary sodium intake in patients with chronic heart failure in the short term. However, the long-term effects are uncertain, and long-term planned randomized controlled trials in heart failure patients are required to further verify the effect in the future.

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