{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T07:28:21Z","timestamp":1793604501318,"version":"4.5.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Exercise training improves cardiorespiratory fitness in patients with heart failure, yet the dose-response relationship across different exercise modalities remains unclear. This study aimed to evaluate the effects of different exercise modalities and their standardized doses on peak oxygen uptake (VO2peak) in patients with heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We systematically searched multiple databases from inception through March 2026 for randomized controlled trials comparing exercise interventions with controls. Exercise modalities were categorized as interval aerobic training (IAT), continuous aerobic training (CAT), resistance training (RT), mind\u2013body training (MBT), and their combinations. Exercise dose was uniformly quantified as weekly metabolic equivalents (MET-min\/week). A Bayesian model-based network dose\u2013response meta-analysis was performed. A total of 100 trials involving 5353 patients were included. The dose\u2013response relationship followed an Emax curve, with ED50 values clustering around 80\u201390 MET-min\/week. A weekly dose of 500 MET-min yielded considerable benefit, and 750\u20131000 MET-min approached maximal benefit for nearly all modalities. The top three ranked interventions were IAT (Emax = 3.50, 95% CrI: 2.49\u20134.60), RT (Emax = 3.66, 95% CrI: 1.96\u20135.85), and IAT + RT (Emax = 3.49, 95% CrI: 1.26\u20135.79).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The exercise dose\u2013response relationship in heart failure follows an Emax curve, with distinct dose\u2013benefit profiles across different exercise modalities. Based on the current evidence, the following preliminary considerations may be offered: for patients with limited exercise tolerance, MBT may be considered as one of the preferred options; for those with moderate exercise tolerance, IAT + RT or CAT + RT may be suitable choices; for patients with good exercise tolerance, IAT or RT may be considered; and for patients with comorbid obesity, CAT may be incorporated into a comprehensive management program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO Registration No<\/jats:title>\n                    <jats:p>CRD420261365071.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lay summary<\/jats:title>\n                    <jats:p>This study analysed 100 trials involving over 5000 patients with heart failure to determine which type and amount of exercise best improve fitness. The key finding is that benefits follow a saturation curve: small amounts bring rapid gains, but beyond 750\u20131000 MET-minutes per week\u2014equivalent to 3\u20134\u2005h of moderate activity\u2014extra exercise provides little added benefit. IAT proved the most efficient strategy, especially for those with limited time. RT offered the greatest maximum gains for patients able to sustain higher training volumes. MBT provides a gentle starting point for those who are frail or anxious about exercising.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag560","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T11:46:24Z","timestamp":1792496784000},"source":"Crossref","is-referenced-by-count":0,"title":["Dose\u2013response associations of exercise modalities with cardiorespiratory fitness in heart failure: a systematic review and Bayesian network meta-analysis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6919-9702","authenticated-orcid":false,"given":"Wei","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Sports and Physical Education, Xi'an Jiaotong University , 28 Xianning West Road, Xi'an, Shanxi Province 710049 ,","place":["China"]},{"name":"Rehabilitation Science Institute, Shanxi Provincial Rehabilitation Hospital , No. 52, Electronic Second Road, Electronic City Street, Yanta District, Xi'an City, Shaanxi Province 710065 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0389-3975","authenticated-orcid":false,"given":"Minghui","family":"Du","sequence":"additional","affiliation":[{"name":"School of Sports and Physical Education, Xi'an Jiaotong University , 28 Xianning West Road, Xi'an, Shanxi Province 710049 ,","place":["China"]},{"name":"Rehabilitation Science Institute, Shanxi Provincial Rehabilitation Hospital , No. 52, Electronic Second Road, Electronic City Street, Yanta District, Xi'an City, Shaanxi Province 710065 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixing","family":"Zhan","sequence":"additional","affiliation":[{"name":"School of Sports and Physical Education, Xi'an Jiaotong University , 28 Xianning West Road, Xi'an, Shanxi Province 710049 ,","place":["China"]},{"name":"Rehabilitation Science Institute, Shanxi Provincial Rehabilitation Hospital , No. 52, Electronic Second Road, Electronic City Street, Yanta District, Xi'an City, Shaanxi Province 710065 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Sports and Physical Education, Xi'an Jiaotong University , 28 Xianning West Road, Xi'an, Shanxi Province 710049 ,","place":["China"]},{"name":"Rehabilitation Science Institute, Shanxi Provincial Rehabilitation Hospital , No. 52, Electronic Second Road, Electronic City Street, Yanta District, Xi'an City, Shaanxi Province 710065 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8467-409X","authenticated-orcid":false,"given":"Longwei","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Sports and Physical Education, Xi'an Jiaotong University , 28 Xianning West Road, Xi'an, Shanxi Province 710049 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