†These authors contributed equally.
Background: Valvular heart disease (VHD) is a type of cardiovascular
disease with abnormal heart valve structure and/or function and a rapidly growing
cause of global cardiovascular morbidity and mortality. Physical inactivity is a
problem for patients with VHD, especially after surgery. However, there is no
data on the effects of exercise on VHD from large multicentre randomised
controlled trials (RCTs). Therefore, we conducted a systematic review and
meta-analysis to provide a comprehensive analysis of small RCTs to evaluate the
effects of exercise on cardiopulmonary function in patients with VHD and provide
an evidence-based medicine basis for developing and guiding the clinical
application of exercise in patients with VHD. Methods: We conducted a
systematic review and meta-analysis of RCTs. We systematically searched
electronic databases (PubMed, Web of Science, Embase, Cochrane Central Register
of Controlled Trials, China National Knowledge Infrastructure [CNKI], China
Science and Technology Journal Database [VIP], WanFang Database, and SinoMed
[CBM]) for all studies on exercise and VHD from their inception to January 2023.
The quality of included studies was assessed using the Cochrane risk-of-bias
tool. The primary outcomes were the six-minute walk test distance (6MWD), left
ventricular ejection fraction (LVEF), and short-form 36-item health survey
(SF-36). Results: This systematic review included 22 RCTs with 1520
subjects (869 men and 651 women). The meta-analysis results showed that exercise
significantly improved exercise capacity measured by the 6MWD (mean difference
[MD] = 25.54, 95% confidence interval [CI] = 19.98–31.11, I