OBJECTIVE: The aim of this review was to investigate the effects of aerobic exercise training, continuous versus intermittent; taking into consideration the effects of different intensities and the total duration, on exercise capacity (VO2max), left ventricle dysfunction, and quality of life in patients with chronic heart failure. METHODS: The meta-analysis was conducted on various electronic database (from 2002 till 2020) of exercise-based rehabilitation trials in heart failure patients. The degree of the intervention effects was determined using effect size for all the outcome variables: VO2max, left ventricular ejection fraction, and quality of life. RESULTS: Nine studies out of 30 articles, including 356 heart failure patients, were included. The patients were divided into three groups: 162 patients were included in the aerobic interval training group, 166 in the moderate continuous training group, and 28 in the control. A significant improvement for VO2max whereas an indicative one for the left ventricular ejection fraction was observed during the aerobic interval training group compared to the moderate continuous training group (p = 0.024 and p = 0.054, respectively). Studies showed low to moderate statistical heterogeneity with I2 estimates ranging between 0% and 45.6%. No significant difference was shown for the quality of life between the 2 groups (p = 0.616). CONCLUSION: This systematic review demonstrated that aerobic high interval training for a period of 12 weeks, 3 times per week and for 40 min at each session, is the appropriate protocol to optimize the enhancement of VO2max and left ventricular ejection fraction in chronic heart failure patients. LEVEL OF EVIDENCE: 2.

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