{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T13:07:43Z","timestamp":1779455263194,"version":"3.53.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The effectiveness of cardiac rehabilitation (CR) after cardiac events and surgeries is well known. However, whether baseline body mass index (BMI) impacts CR outcomes is unclear. This first systematic review and meta-analysis of literature examined the difference in CR outcomes based on various BMI categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Web of Science, Embase, PubMed, and Scopus databases were searched until October 6, 2025, for all studies examining the outcomes of CR based on BMI. The primary outcome was the change in exercise capacity [as measured by changes in metabolic equivalents (METs)]. In contrast, secondary outcomes included changes in BMI, lipid profile, resting heart rate, and resting blood pressure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighteen studies were included. In the comparison of obese vs. non-obese participants, pooled results showed no significant difference in the change in METs between the two groups. Subgroup analyses based on study design and obesity definition did not alter the overall findings. Among secondary outcomes, the change in BMI was not significantly different between the groups. Additionally, total cholesterol levels improved slightly more in non-obese individuals; however, there were no significant differences observed for high-density lipoprotein (HDL), triglycerides, heart rate, or blood pressure. In the comparison of overweight vs. normal BMI groups, no significant differences were observed for change in METs or BMI. Similarly, total cholesterol and HDL levels did not differ significantly between groups, although triglyceride reduction was greater among patients with a normal BMI. High heterogeneity was noted in most analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results indicate that pre-rehabilitation BMI does not affect improvements in exercise capacity and lipid profile in CR patients. Variations in CR protocols and high inter-study heterogeneity prohibit firm conclusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251153489<\/jats:ext-link>\n                      , identifier CRD420251153489.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1757861","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T12:31:33Z","timestamp":1779453093000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of body mass index on outcomes of cardiac rehabilitation: a systematic review and 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