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Abstract
Objective Children and adults with repaired tetralogy of Fallot (rTOF) have an impaired exercise capacity, a less active lifestyle and an increased long-term risk of adverse outcomes compared with healthy peers. This study aimed to summarise the current evidence for the effectiveness and safety of exercise training interventions in patients with rTOF.
Methods PubMed/MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus and reference lists of relevant articles were searched for prospective studies published by November 2021. Random-effects meta-analysis and descriptive synthesis were performed to assess the effectiveness and safety of exercise training in patients with rTOF.
Results Of the 9677 citations identified, 12 articles were included that reported on 10 unique studies and covered 208 patients with rTOF (range of mean/median age: 7.4–43.3 years). All studies implemented 2 to 7 aerobic or respiratory training sessions per week with durations ranging from 6 to 26 weeks. Meta-analysis of the included randomised controlled trials showed that exercise training was associated with a significant improvement in peak VO2 (pooled mean difference: +3.1 mL/min/kg; 95% CI: 0.76 to 5.36 mL/min/kg, p=0.019). Cardiac imaging studies revealed no subclinical adverse remodelling after the exercise interventions. No serious adverse events including arrhythmias were reported in these studies.
Conclusion Current evidence suggests that exercise training can improve exercise capacity in patients with rTOF with a low risk for adverse events. Exercise prescription may be a safe and effective tool to help improving outcomes in patients with rTOF.
PROSPERO registration number CRD42021292809.
Data availability statement
Data are available on reasonable request.
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Data availability statement
Data are available on reasonable request.
Footnotes
Twitter @artschuermans, @JefVandenEynde, @MoonsPhilip, @alexvdbruaene, @WernerBudts
Contributors AS: concept/design, data collection, data interpretation, statistical analysis, drafting article, critical revision of article, approval of article. MB: data collection, data interpretation, critical revision of article, approval of article. GAS: data collection, data interpretation, critical revision of article, approval of article. JVdE: concept/design, data interpretation, critical revision of article, approval of article. JJMT: data interpretation, critical revision of article, approval of article. WAH: data interpretation, critical revision of article, approval of article. TG: data interpretation, critical revision of article, approval of article. PM: data interpretation, critical revision of article, approval of article. AVDB: data interpretation, critical revision of article, approval of article. WB: data interpretation, critical revision of article, approval of article. AS accepts full responsibility for the finished work and/or the conduct of the study, had access to the data, and controlled the decision to publish.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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