The ExTraMATCH meta-analysis aimed to determine the effect of exercise training on survival in patients with chronic heart failure due to left ventricular systolic dysfunction. The study included nine randomized controlled trials with a total of 801 patients, where 395 received exercise training and 406 were controls. The primary outcome measure was death from all causes, and the secondary endpoint was death or admission to the hospital. During a mean follow-up of 705 days, there were 88 deaths in the exercise group (22%) and 105 in the control group (26%). Exercise training significantly reduced mortality (hazard ratio 0.65, 95% CI 0.46 to 0.92) and the secondary endpoint (hazard ratio 0.72, 95% CI 0.56 to 0.93). No significant subgroup-specific treatment effects were observed. The meta-analysis concluded that properly supervised exercise training programs do not pose a risk and are associated with a clear reduction in mortality. Further research should focus on optimizing exercise programs and identifying appropriate patient groups.The ExTraMATCH meta-analysis aimed to determine the effect of exercise training on survival in patients with chronic heart failure due to left ventricular systolic dysfunction. The study included nine randomized controlled trials with a total of 801 patients, where 395 received exercise training and 406 were controls. The primary outcome measure was death from all causes, and the secondary endpoint was death or admission to the hospital. During a mean follow-up of 705 days, there were 88 deaths in the exercise group (22%) and 105 in the control group (26%). Exercise training significantly reduced mortality (hazard ratio 0.65, 95% CI 0.46 to 0.92) and the secondary endpoint (hazard ratio 0.72, 95% CI 0.56 to 0.93). No significant subgroup-specific treatment effects were observed. The meta-analysis concluded that properly supervised exercise training programs do not pose a risk and are associated with a clear reduction in mortality. Further research should focus on optimizing exercise programs and identifying appropriate patient groups.