A2 Review article, Literature review, Systematic review
Exercise type and settings, quality of life, and mental health in coronary artery disease : a network meta-analysis (2025)
Toval, A., Bakker, E. A., Granada-Maia, J. B., Núñez de Arenas-Arroyo, S., Solis-Urra, P., Eijsvogels, T. M. H., Esteban-Cornejo, I., Martínez-Vizcaíno, V., & Ortega, F. B. (2025). Exercise type and settings, quality of life, and mental health in coronary artery disease : a network meta-analysis. European Heart Journal, Early online. https://doi.org/10.1093/eurheartj/ehae870
JYU authors or editors
Publication details
All authors or editors: Toval, Angel; Bakker, Esmée A.; Granada-Maia, Joao Bruno; Núñez de Arenas-Arroyo, Sergio; Solis-Urra, Patricio; Eijsvogels, Thijs M. H.; Esteban-Cornejo, Irene; Martínez-Vizcaíno, Vicente; Ortega, Francisco B.
Journal or series: European Heart Journal
ISSN: 0195-668X
eISSN: 1522-9645
Publication year: 2025
Publication date: 15/01/2025
Volume: Early online
Publisher: Oxford University Press
Publication country: United Kingdom
Publication language: English
DOI: https://doi.org/10.1093/eurheartj/ehae870
Publication open access: Openly available
Publication channel open access: Partially open access channel
Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/99769
Abstract
Methods: A systematic search was conducted and a network meta-analysis compared (i) exercise types, high-intensity interval training (HIIT), HIIT + resistance (HIIT + R), moderate-intensity training (MIT), MIT + R and stretching-toning-balance training, and (ii) exercise settings, in-person and home-based.
Results: A total of 42 randomized controlled trials with a parallel group design were identified, of which 36 were included in the meta-analysis. Few studies included cognition (n = 2), sleep (n = 2), and none brain structure/function (n = 0). Most studies examined HR-QoL (n = 30), depression (n = 15), and anxiety (n = 9), in which outcomes were meta-analysed. HIIT + R, HIIT, and MIT were associated with improved HR-QoL vs. no exercise (i.e. usual care) [standardized mean difference, SMD: 1.53 (95% confidence interval 0.83; 2.24), 0.44 (0.15; 0.73), and 0.44 (0.20; 0.67), respectively]. In-person exercise was associated with larger and significant improvements [HR-QoL SMD: 0.51 (0.28; 0.74), depressive SMD: -0.55 (-1.03; -0.07), and anxiety symptoms SMD: -1.16 (-2.05; -0.26)] compared with no exercise, whereas home-based programmes were not significantly associated with improvements in these outcomes. Findings were robust in secondary (i.e. intervention duration and volume) and sensitivity analyses excluding high risk of bias studies.
Conclusions: Exercise training, especially in-person sessions, was associated with improved HR-QoL, depression and anxiety, independently of exercise type. However, this study raises concern about the effectiveness of home-based programmes in improving these outcomes.Study protocol was registered in PROSPERO (ID: CRD42023402569).
Keywords: brain; cardiovascular diseases; coronary artery disease; aerobic training; training; cerebrovascular disorders; mental well-being; quality of life
Free keywords: brain; cardiovascular disease; cognition; coronary heart disease; exercise; ischaemic disease; mental health
Contributing organizations
Ministry reporting: Yes
VIRTA submission year: 2025
Preliminary JUFO rating: 3