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IHD Chest Pain – Improves how effectively your heart beats

Evidence summary (Updated 2022)
A small body of good quality randomised controlled data shows physical activity will have improve left ventricular ejection fraction(1–3).
A more recent review showed that while left ventricular ejection fraction (LVEF) was significantly improved (MD = 2.82, 95% CI [1.50, 4.14], p < 0.05); left ventricular end diastolic diameter was not significantly improved with exercise interventions.(4)

When considering types of physical activity, HIIT has been shown to generally have better evidence supporting improvements in LVEF in patients after PCI (percutaneous coronary intervention) in a SR and MA of 6 RCTs of 247 patients.(5)

Quality of Evidence
B – moderate quality

Strength of recommendation
1 – strong recommendation

Physical activity can be recommended to improve the coronary flood flow in most patients with ischaemic heart disease and should be undertaken unless there are compelling reasons to do so.


  1. Adams V, Besler C, Fischer T, Riwanto M, Noack F, Hollriegel R, et al. Exercise training in patients with chronic heart failure promotes restoration of high-density lipoprotein functional properties. Circ Res. 113:1345–1355.
  2. Erbs S, Hollriegel R, Linke A, Beck EB, Adams V, Gielen S, et al. Exercise training in patients with advanced chronic heart failure (NYHA IIIb) promotes restoration of peripheral vasomotor function, induction of endogenous regeneration, and improvement of left ventricular function. Circ Hear Fail. 3:486–494.
  3. Amundsen BH, Rognmo O, Hatlen-Rebhan G, Slordahl SA. High-intensity aerobic exercise improves diastolic function in coronary artery disease. Scand Cardiovasc J. 42(110).
  4. Zhang H, Chang R. Effects of Exercise after Percutaneous Coronary Intervention on Cardiac Function and Cardiovascular Adverse Events in Patients with Coronary Heart Disease: Systematic Review and Meta-Analysis. J Sports Sci Med [Internet]. 2019 [cited 2022 Oct 7];18(2):213. Available from: /pmc/articles/PMC6543998/
  5. Zhang X, Xu D, Sun G, Jiang Z, Tian J, Shan Q. Effects of high-intensity interval training in patients with coronary artery disease after percutaneous coronary intervention: A systematic review and meta-analysis. Nurs open [Internet]. 2021 May 1 [cited 2022 Oct 7];8(3):1424–35. Available from: