Synergistic effects of combined breathing training and aerobic exercise on cardiopulmonary function in chronic heart failure: a systematic review and meta-analysis.

Combined breathing training and aerobic exercise significantly improved exercise duration in chronic heart failure patients compared to control groups.

• SMD = 0.32, 95% CI [0.05 to 0.60], p = 0.02
• Seven randomized controlled trials involving 246 patients were included
• Analysis performed using RevMan 5.4 and Stata 17.0
• All databases searched from inception to April 2025

Combined breathing training and aerobic exercise significantly improved quality of life in chronic heart failure patients compared to control groups.

• SMD = -1.09, 95% CI [-1.78 to -0.40], p < 0.001
• The negative SMD value indicates improvement on quality of life scales
• Finding was based on seven RCTs with 246 total patients
• Sensitivity analyses confirmed the robustness of these findings

No significant effects of combined breathing training and aerobic exercise were observed on cardiac function parameters.

• Cardiac function parameters did not show statistically significant improvements compared to control groups
• This finding was based on meta-analysis of seven randomized controlled trials involving 246 patients
• The impact on cardiac function parameters was described as 'limited'
• The authors note this contrasts with positive effects seen on pulmonary function and cardiopulmonary exercise capacity

Combined breathing training and aerobic exercise had positive effects on pulmonary function and cardiopulmonary exercise capacity in chronic heart failure patients.

• Seven randomized controlled trials involving 246 patients were included in the analysis
• Studies were identified from both Chinese and international databases
• Two reviewers independently screened studies, extracted data, and assessed risk of bias
• The systematic review was registered with PROSPERO under registration number CRD420251014242

Subgroup analyses suggested that sex composition may influence the effects of combined breathing training and aerobic exercise interventions.

• Subgroup analyses were performed to investigate factors influencing intervention effects
• Sex composition was identified as one factor that may influence intervention effects
• Sensitivity analyses confirmed the robustness of the overall findings
• The limited number and quality of included studies (7 RCTs, 246 patients) constrain the strength of these conclusions

The authors concluded that the optimal intervention duration for combined breathing training and aerobic exercise in chronic heart failure requires further confirmation in high-quality research.

• The conclusions were based on only seven randomized controlled trials involving 246 patients
• The authors explicitly noted 'the limited number and quality of the included studies'
• Both the main conclusions and optimal intervention duration were identified as requiring further confirmation
• High-quality future research was recommended to validate these findings