The ExTraMATCH collaborative meta-analysis of randomized controlled trials found that exercise training significantly reduces mortality and hospital admission in patients with chronic heart failure due to left ventricular systolic dysfunction. A total of 801 patients were included in the analysis, with 395 in the exercise group and 406 in the control group. Over a mean follow-up of 705 days, 88 deaths occurred in the exercise group compared to 105 in the control group, indicating a hazard ratio of 0.65 (95% CI 0.46 to 0.92). The secondary endpoint of death or hospital admission was also reduced (hazard ratio 0.72, 95% CI 0.56 to 0.93). No statistically significant subgroup-specific treatment effect was observed. The study concluded that exercise training is safe and beneficial for patients with chronic heart failure, with clear evidence of reduced mortality. Further research should focus on optimizing exercise programs and identifying appropriate patient groups. The study found no evidence of publication bias and confirmed the benefits of exercise training in improving survival and reducing hospital admissions. The results suggest that supervised exercise training is a valuable intervention for patients with chronic heart failure.The ExTraMATCH collaborative meta-analysis of randomized controlled trials found that exercise training significantly reduces mortality and hospital admission in patients with chronic heart failure due to left ventricular systolic dysfunction. A total of 801 patients were included in the analysis, with 395 in the exercise group and 406 in the control group. Over a mean follow-up of 705 days, 88 deaths occurred in the exercise group compared to 105 in the control group, indicating a hazard ratio of 0.65 (95% CI 0.46 to 0.92). The secondary endpoint of death or hospital admission was also reduced (hazard ratio 0.72, 95% CI 0.56 to 0.93). No statistically significant subgroup-specific treatment effect was observed. The study concluded that exercise training is safe and beneficial for patients with chronic heart failure, with clear evidence of reduced mortality. Further research should focus on optimizing exercise programs and identifying appropriate patient groups. The study found no evidence of publication bias and confirmed the benefits of exercise training in improving survival and reducing hospital admissions. The results suggest that supervised exercise training is a valuable intervention for patients with chronic heart failure.