Impact of Exercise Modalities on Peripheral and Central Components of Cardiorespiratory Capacity in Heart Transplantation Patients: A Systematic Review and Meta-Analysis.

Background and Objectives: To analyze the effects of aerobic, resistance, and combined training on peripheral and central components related to cardiorespiratory capacity after HTx. Materials and Methods : No time restriction was applied for study inclusion. MEDLINE/PubMed; EMBASE, CENTRAL, and PEDro databases were investigated. Studies reporting heart transplanted patients older than 19 years following aerobic, resistance, and combined training according. The outcomes included: V'O 2 peak, VE/V'CO 2 slope, heart rate (HR peak), systolic and diastolic blood pressure (SBP and DBP peak), maximum repetition test(1RM), sit-to-stand test, and flow-mediated dilation (FMD). The studies were selected by consensus. Four hundred ninety-two studies initially met the selection criteria. Cochrane handbook was used for abstracting data and assessing data quality and validity. Independent extraction by two observers was applied. Results : Isolated aerobic training leads to a greater increase in V'O 2 peak than combined training compared to the control group ( p < 0.001, I2 = 0%). However, no significant differences were found in the subgroup comparison ( p = 0.19, I2 = 42.1%). HR peak increased similarly after aerobic and combined training. High-intensity interval training (HIIT) was better than moderate continuous intensity to increase the V'O 2 after long term in HTx. Still, there is scarce evidence of HIIT on muscle strength and FMD. No change on VE/V'CO 2 slope, FMD, and SBP, DBP peak. 1RM and the sit-to-stand test increased after resistance training ( p < 0.001, I2 = 70%) and CT ( p < 0.001, I2 = 0%) when compared to control. Conclusions : Aerobic and combined training effectively improve VO 2 peak and muscle strength, respectively. HIIT seems the better choice for cardiorespiratory capacity improvements. More studies are needed to examine the impact of training modalities on VE/V'CO 2 slope and FMD.