Heart Failure as a Newly Approved Diagnosis for Cardiac Rehabilitation: Challenges and Opportunities

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Public Health

Background:

• Cardiac rehabilitation (CR) eligibility has expanded to include heart failure with reduced ejection fraction (HFrEF).
• Despite this expansion, CR enrollment for coronary heart disease patients has remained low for decades.
• Understanding and overcoming barriers to CR utilization is crucial for improving patient outcomes.

Purpose of the Study:

• To review entrenched obstacles impeding the utilization of cardiac rehabilitation (CR).
• To examine the potential of CR in managing heart failure with reduced ejection fraction (HFrEF).
• To identify gaps in current research and clinical practice regarding CR for heart failure patients.

Main Methods:

• Literature review focusing on barriers to CR enrollment and adherence.
• Analysis of the HF-ACTION trial's contribution and limitations.
• Examination of CR utility for heart failure with preserved ejection fraction (HFpEF) and patient adherence challenges.

Main Results:

• Long-standing low enrollment in CR persists despite broadened eligibility.
• Entrenched obstacles hinder CR utilization, particularly for HFrEF patients.
• Gaps remain regarding CR for HFpEF and strategies to improve patient adherence.

Conclusions:

• Expanded CR eligibility alone is insufficient to increase enrollment.
• Addressing systemic barriers and patient adherence is critical for successful CR implementation in heart failure.
• Further research is needed on CR for HFpEF and optimizing long-term patient engagement.