Mode
Text Size
Log in / Sign up

Network meta-analysis reveals resistance training offers largest LVEF gains for adult heart failure patients compared to other exercise typesResistance training shows greatest heart function boost in network analysis

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Resistance training showed the largest LVEF improvement with a mean difference of 9.9 points and highest SUCRA probability of 93.1%.

This network meta-analysis evaluated five exercise interventions against control in adult patients with heart failure. The study included aerobic exercise, resistance training, combined exercise, mind-body exercise, and high-intensity interval training. Researchers analyzed data from 3,519 participants to determine which approach most effectively improved left ventricular ejection fraction.

results showed that resistance training produced the largest treatment effect with a mean difference of 9.9 percentage points. High-intensity interval training followed as the second most effective intervention with a mean difference of 8.4 points. Combined exercise and aerobic exercise ranked third and fourth respectively, demonstrating smaller but still positive effects on cardiac function.

SUCRA ranking probabilities confirmed resistance training as the optimal choice with a 93.1% probability of being the best intervention. Dose-response analysis indicated a non-linear quadratic relationship between exercise volume and LVEF improvement. The optimal dosage range for general exercise was found between 500 and 800 MET-minutes per week.

Evidence certainty ranged from very low to moderate across comparisons per CINeMA framework. These findings support a precision-based rehabilitation strategy centered on resistance training to optimize cardiac function in this population.

A large network meta-analysis examined how different exercise types affect heart function in adults with heart failure. The study included 3,519 participants and compared aerobic exercise, resistance training, combined exercise, mind-body exercise, and high-intensity interval training against a control group. Researchers looked specifically at changes in left ventricular ejection fraction, a key measure of heart pumping strength.

The analysis ranked resistance training as having the largest effect on improving heart function. High-intensity interval training and combined exercise also showed strong benefits, while aerobic exercise ranked fourth. The study used a statistical method called SUCRA to estimate the probability that each exercise type was the best option. Resistance training had the highest probability of being optimal.

The researchers also found a non-linear relationship between exercise volume and heart function improvement. For resistance training, benefits appeared at lower doses, while high-intensity interval training required higher thresholds to be effective. The study notes that evidence certainty ranged from very low to moderate across comparisons. Safety data were not reported in the source. Readers should take these findings as supportive of a precision-based rehabilitation strategy but not as definitive proof of safety or broad clinical outcomes.

What this means for you:
Resistance training showed the greatest improvement in heart function, though evidence certainty ranges from very low to moderate.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
ObjectiveTo compare the effects of various exercise modalities and doses on left ventricular ejection fraction (LVEF) in patients with heart failure.MethodsWe systematically searched eight electronic databases through December 2025. Randomized controlled trials involving adult HF patients were eligible. Interventions comprised aerobic exercise (AE), resistance training (RT), combined exercise (CE), mind-body exercise (ME), high-intensity interval training (HIIT), and control. Random-effects network meta-analysis was employed to estimate mean differences with 95% credible intervals, and surface under the cumulative ranking curve probabilities were calculated. Nonlinear dose-response relationships were modeled using MET-minutes per week.Results42 RCTs comprising 3,519 participants were included. Network meta-analysis demonstrated that all exercise modalities significantly improved LVEF compared with control. Resistance training showed the largest treatment effect (MD: 9.9; 95% CrI: 6.5, 13.0), followed by HIIT (MD: 8.4; 95% CrI: 4.2, 12.0), CE (MD: 6.0; 95% CrI: 2.9, 9.0), and AE (MD: 5.2; 95% CrI: 3.3, 7.1). SUCRA rankings indicated RT had the highest probability of being optimal (93.1%), followed by HIIT (76.1%), ME (55.3%), CE (46.0%), and AE (29.5%). Dose-response analysis revealed a non-linear quadratic relationship between MET-minutes per week and LVEF improvement. The minimum effective dose was 280 MET-minutes/week, with the optimal dosage range of 500–800 MET-minutes/week. Modality-specific patterns emerged: RT produced benefits at low doses (220 MET-minutes/week; optimal 330–440), whereas HIIT required higher thresholds (440 MET-minutes/week; optimal 560–780). Evidence certainty ranged from very low to moderate across comparisons per CINeMA framework.ConclusionsResistance training is the most effective exercise modality for improving LVEF in HF patients, particularly at low-to-moderate doses. These findings support a precision-based rehabilitation strategy centered on RT to optimize cardiac function.Systematic Review RegistrationPROSPERO, CRD420261329239.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.