Effects of calorie restriction therapy on health-related outcomes in patients with heart failure, a systematic review and meta-analysis

Aims: We conducted this systematic review to comprehensively assess the impact of CRT on health-related outcomes among patients with HF. Data synthesis: In order to find studies investigating the effect of CRT on health-related outcomes among patients with HF, we performed a systematic search of PubMed, Cochrane Library, Embase, and Cumulative Index to Nursing and Allied Health Literature databases (inception until February 12th, 2023). A total of 10 studies including 933 individuals met the inclusion criteria. The systematic review indicated that 8 to 24 weeks of CRT intervention offered some health advantages for patients with HF. CRT significantly reduced patients' body weight (SMD =- 0.52, 95 % CI =- 0.99 to-0.04, P = 0.03, I2 = 77 %) and improved their quality of life (SMD = 0.35,95% CI = 0.12 to 0.58, P = 0.003, I2 = 0%). However, CRT significantly increased the risk of mortality and HF-related rehospitalization, including combined events of all-cause mortality and HF-related rehospitalization within a year (CRT group: 20 % vs. control group: 5 %), mortality rate within 1.52 years (CRT group: 34 % vs. control group: 22 %), readmission rate (CRT group: 52 % vs. control group: 17 %), and length of stay after readmission (CRT group: 124 days vs. control group:18 days). Conclusion: CRT provides no significant benefits in terms of health-related outcomes among patients with HF, hence most patients with HF might not be eligible for CRT treatments. Meanwhile, there are several methodological issues among the studies included in the review, resulting in a low-to-moderate quality of evidence. Registration: The PROSPERO registration number of this review is CRD 42023413992.