Is Exercise Training Beneficial for Heart Failure Patients Taking β-Adrenergic Blockers? A Systematic Review and Meta-Analysis

The authors sought to conduct a systematic review comparing the effects of exercise training in heart failure patients taking β-blockers vs those not. A systematic search of exercise training trials in chronic heart failure patients that compared groups who took β-blocker medication or compared selective and nonselective β-blockers during exercise training was conducted. Eight prospective studies met the criteria for the quantitative synthesis, which included data from 236 participants. The increment in peak oxygen consumption (VO₂) was greater in exercising vs control participants, with a mean difference (MD) of 1.27 mL/kg/min (95% confidence interval [CI], 0.85-1.70; P<.00001). In exercising patients, the increment in peak VO₂ was greater in the group taking β-blocker vs those taking placebo (MD, 1.66 mL/kg/min; 95% CI, 0.36-2.97; P=.01). In exercising patients, there was no difference in the increment of peak VO₂ between nonselective β-blocker and selective β-blockers groups (MD, -0.09 mL/kg/min; 95% CI, -1.54-1.36; P=.09). Minnesota Quality of Life Score was significantly better in the exercise group vs sedentary control group (both groups taking β-blockers) (MD, -11.3; 95% CI, -15.9 to -6.8; P<.00001). Our analysis demonstrated that β-adrenergic blocker therapy did not reduce exercise capacity or exercise training adaptations and quality of life in heart failure patients.