PURPOSE: To compare the effects of combined training (CT) versus aerobic training (AT) or versus control on VO2 peak and quadriceps muscle strength in patients with heart failure (HF). MATERIALS AND METHODS: Major electronic databases were searched, from inception to November 2020, for randomized clinical trials comparing the effects of CT against AT or control on VO peak and/or quadriceps muscle strength in patients with HF. Random effects meta-analyses were conducted, calculating the standardized mean difference (SMD). RESULTS: Twenty-eight articles were included. An increase on VO peak (SMD = 0.77, 95% CI 0.39 to 1.14, I = 80.1%) and quadriceps muscle strength (SMD = 0.67, 95% CI 0.18 to 1.16, I = 0%) was found in CT compared to control. CT increased quadriceps muscle strength, versus AT (SMD = 0.44, 95%CI 0.15 to 0.74, I = 0%). There were no differences between CT and AT on VO2 peak (SMD=-0.01, 95% CI -0.36 to 0.34, I = 65%). Time of session and training duration moderate the effects of CT over control on VO peak. CONCLUSIONS: CT promotes increases on quadriceps muscle strength and aerobic capacity over control and provides additional gains on quadriceps muscle strength, having the same effects on VO peak compared to AT. A longer time of session is associated with greater benefits to aerobic capacity.

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