Exercise-based cardiac rehabilitation for adults with heart failure

Long, Linda; Mordi, Ify; Bridges, Charlene; Sagar, Viral A; Davies, Edward J.; Coats, Andrew J.S.; Dalal, Hasnain M; Rees, Karen; Singh, Sally; Taylor, Rod S

doi:10.1002/14651858.cd003331.pub5

Cited by 357 publications

(391 citation statements)

References 215 publications

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“…173 Exercise training. A new meta-analysis 174 and the Cochrane meta-analysis 175 involved 44 studies that included 5783 people with heart failure with reduced ejection fraction (HFrEF), and had findings consistent with those of the previous (2014) version of the Cochrane review: significant reductions in overall hospital admissions, as well as in HF admissions. These findings have recently been confirmed by the CROS-HF meta-analysis and review.…”

Section: Heart Failurementioning

confidence: 99%

Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology

Piepoli

Abreu

Albus

et al. 2019

Eur J Prev Cardiolog

180

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European guidelines on cardiovascular prevention in clinical practice were first published in 1994 and have been regularly updated, most recently in 2016, by the Sixth European Joint Task Force. Given the amount of new information that has become available since then, components from the task force and experts from the European Association of Preventive Cardiology of the European Society of Cardiology were invited to provide a summary and critical review of the most important new studies and evidence since the latest guidelines were published. The structure of the document follows that of the previous document and has six parts: Introduction (epidemiology and cost effectiveness); Cardiovascular risk; How to intervene at the population level; How to intervene at the individual level; Disease-specific interventions; and Settings: where to intervene? In fact, in keeping with the guidelines, greater emphasis has been put on a population-based approach and on disease-specific interventions, avoiding re-interpretation of information already and previously considered. Finally, the presence of several gaps in the knowledge is highlighted.

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Section: Heart Failurementioning

confidence: 99%

Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology

Piepoli

Abreu

Albus

et al. 2019

Eur J Prev Cardiolog

180

View full text Add to dashboard Cite

show abstract

“…Despite exercise-based CR having limited impact on patient survival [8,15], patients with CHD (RD − 0.05; 95 % CI − 0.10 to − 0.00; P = 0.05) [15] and CHF may still benefit from fewer hospital admissions (RR 0.70; 95 % CI 0.60 to 0.83) [8]. Furthermore, exercisebased CR may improve patients' health-related quality of life [8,21] and improve cardiometabolic risk factors [22,23] which could allow patients to reduce the number and/or dose of secondary prevention medications, although further research is needed to confirm this assertion. In light of these findings, practitioners should continue to explore ways of optimising exercise-based CR.…”

Section: Clinical Benefit Of Cardiac Rehabilitationmentioning

confidence: 99%

“…'reconditioning' patients with heart disease [4] and, in 1993, recommended that exercise training become a key component of cardiac rehabilitation (CR) [5]. Exercise training is now considered a core component of a comprehensive CR programme [6] and is thought to improve patient survival [7] and quality of life [8]. However, despite the wide application of exercise training in CR, controversy relating to best practice remains.…”

Section: Introductionmentioning

confidence: 99%

Current Insights into Exercise-based Cardiac Rehabilitation in Patients with Coronary Heart Disease and Chronic Heart Failure

et al. 2020

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AbstractCardiac rehabilitation is a package of lifestyle secondary prevention strategies designed for patients with coronary heart disease and chronic heart failure. A community-based cardiac rehabilitation programme provides patients with a structured exercise training intervention alongside educational support and psychological counselling. This review provides an update regarding the clinical benefits of community-based cardiac rehabilitation from a psycho-physiological perspective, and also focuses on the latest epidemiological evidence regarding potential survival benefits. Behaviour change is key to long-term adoption of a healthy and active lifestyle following a cardiac event. In order for lifestyle interventions such as structured exercise interventions to be adopted by patients, practitioners need to ensure that behaviour change programmes are mapped against patient’s priorities and values, and adapted to their level of readiness and intention to engage with the target behaviour. We review the evidence regarding behaviour change strategies for cardiac patients and provide practitioners with the latest guidance. The ‘dose’ of exercise training delivered to patients attending exercise-based cardiac rehabilitation is an important consideration because an improvement in peak oxygen uptake requires an adequate physiological stimulus to invoke positive physiological adaptation. We conclude by critically reviewing the latest evidence regarding exercise dose for cardiac patients including the role of traditional and more contemporary training interventions including high intensity interval training.

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“…In patients with HF, research suggested that exercise-based CR could improve QoL, decrease all-cause hospital admissions and HF-dependent hospital admissions in the short term (up to 12 months) and potentially reduce mortality in the long term when compared to no exercise patients [16,17] . Our study expands the previous research by showing that early rehabilitation program involving supervised regular exercise and electrical stimulation can reduce the incidence of cardiac death in patients with HFrEF, and heart failure re-hospitalization in patients with HFmrEF.…”

Section: Discussionmentioning

confidence: 99%

Early Cardiac Rehabilitation Improved Prognosis in Patients with Heart Failure Following Acute Myocardial Infarction

Cai¹,

Cao²,

Sun³

et al. 2020

Preprint

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Background: Cardiac rehabilitation (CR) has been shown to improve exercise intolerance and QoL, and minimize re-hospitalizations in patients with congestive heart failure (CHF). However, studies on early CR in patients with acute myocardial infarction (AMI) who developed CHF following percutaneous coronary intervention (PCI) are rare. The purpose of this study is to evaluate the effectiveness of early CR on patients with CHF after AMI following PCI.Methods: Two hundred thirty-seven patients who developed heart failure after AMI following PCI were enrolled. Patients were divided into heart failure with reduced ejection fraction (HFrEF) group and heart failure with mid-range ejection fraction (HFmrEF) group. Of which, 78 patients who accepted a two-week CR were further divided into two subgroups based on major adverse cardiovascular events (MACE). Key cardio-pulmonary exercise testing (CPX) variables that may affect the prognosis were identified through the comparison of the cardio-respiratory fitness (CRF).Results: Early CR significantly reduced cardiac death in patients with HFrEF, and reduced re-hospitalization in patients with HFmrEF after AMI (P <0.01). Serum potassium and CR ratio were independent risk factors for MACE in patients with both HFrEF and HFmrEF after AMI. In the CR group who developed MACE, there were more diabetics (P=0.035), with higher serum potassium (P=0.043), and lower PETCO2 at VT (P=0.016). PETCO2 at VT was an independent risk factor for re-hospitalization. The incidence of re-hospitalization was significantly lower when the PETCO2 at VT was greater than 33.5mmHg (P=0.03).Conclusions: Early CR reduced the incidence of MACE in patients with heart failure after AMI following PCI. The PETCO2 at VT is an independent risk factor for re-hospitalization, and could be used as a key evaluating hallmark for early CR in patients who developed heart failure after AMI.

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Exercise-based cardiac rehabilitation for adults with heart failure

Cited by 357 publications

References 215 publications

Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology

Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology

Current Insights into Exercise-based Cardiac Rehabilitation in Patients with Coronary Heart Disease and Chronic Heart Failure

Early Cardiac Rehabilitation Improved Prognosis in Patients with Heart Failure Following Acute Myocardial Infarction

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