{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:04:53Z","timestamp":1788822293052,"version":"build-2803163510"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"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>Introduction<\/jats:title>\n                    <jats:p>Heart failure with preserved ejection fraction (HFpEF) is associated with substantial functional limitation and recurrent hospitalization, while effective pharmacological options remain limited. Exercise-based cardiac rehabilitation (CR) has been proposed as a non-pharmacological strategy; however, its effects on clinical and functional outcomes in HFpEF remain incompletely defined.This meta-analysis aimed to systematically assess the impact of exercise-based CR on rehospitalization, mortality, functional capacity, quality of life, and cardiac function in patients with HFpEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted according to PRISMA guidelines, with electronic database searches performed through December 2024.Nineteen randomized controlled trials involving 2,025 participants were included. Meta-analyses were performed using RevMan 5.4, with effect estimates expressed as risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Exercise-based CR did not significantly reduce all-cause mortality (RR 1.13, 95% CI 0.77\u20131.66), but was associated with a significantly lower risk of rehospitalization (RR 0.52, 95% CI 0.38\u20130.72). Significant improvements were observed in functional exercise capacity, including 6-minute walk distance (MD 36.89m) and peak oxygen uptake (VO\u2082peak; MD 2.14mL\/kg\/min), as well as physical functioning assessed by the SF-36. Exercise-based CR was also associated with a modest reduction in left atrial volume index, whereas left ventricular ejection fraction remained unchanged. In addition, peak heart rate significantly improved (MD 7.74 bpm, 95% CI 3.68\u201311.80). Data on blood pressure, lipid profile, glycemic control, and cardiovascular mortality were limited or inconsistently reported, precluding meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exercise-based cardiac rehabilitation improves functional capacity,cardiorespiratory fitness,and physical quality of life in patients with HFpEF and reduces rehospitalization risk, although no mortality benefit was observed.<\/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\/display_record.php?RecordID=1069784<\/jats:ext-link>\n                      , PROSPERO CRD420251069784.\n                    <\/jats:p>\n                  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