Heart rate recovery in heart failure patients after a 12-week cardiac rehabilitation program

Heart rate recovery (HRR) after maximal exercise is a predictor of all-cause mortality. It was hypothesized that aerobic exercise training would increase HRR in patients with heart failure (HF), because it has been shown to be accelerated in athletes and improved in patients with coronary artery disease after cardiac rehabilitation. To date, no study has examined the effects of exercise training on HRR in HF. This was a retrospective study of patients with HF who had completed a phase II aerobic cardiac rehabilitation program with entry and exit maximal stress tests (n = 46). Thirty-five patients exhibited a training effect, 18 had abnormal HRR of < or =12 beats/min and the lowest initial functional capacity (L12), and 17 had HRR of >12 beats/min before training (G12). A group of 11 other patients did not achieve a training effect. After training, the L12 and G12 groups improved their estimated peak oxygen uptake (by 6.7 +/- 3.1 and 8.6 ml/kg/min, respectively) and treadmill time (by 117 +/- 62 and 181 +/- 108 seconds, respectively) compared with the no-training effect group (p <0.05). Only the L12 group demonstrated improvement in HRR (7 +/- 1 to 12 +/- 2 beats/min). In conclusion, the results indicate that short-term aerobic training can favorably modify HRR in patients with HF with low exercise capacity.