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Clinical Perspectives on Cardiac Rehabilitation After Heart Failure in Elderly Patients with Frailty: A Narrative

Daichi Tsukakoshi1, Shuhei Yamamoto1, Shuhei Takeda1

  • 1Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan.

Therapeutics and Clinical Risk Management
|November 3, 2022
PubMed

Insights

Heart failure and frailty often coexist, increasing patient risk. Comprehensive rehabilitation, addressing physical, cognitive, and social factors, is crucial for improving outcomes in these complex patients.

Area of Science:

  • Cardiology
  • Geriatrics
  • Rehabilitation Medicine

Background:

  • Ischemic heart disease is a leading global cause of mortality.
  • Heart failure is a growing pandemic due to aging populations.
  • Frailty is increasingly recognized as a significant risk factor for heart failure, morbidity, and mortality.

Purpose of the Study:

  • To review rehabilitation modalities for heart failure patients with frailty.
  • To emphasize the need for comprehensive interventions beyond physical frailty.
  • To highlight the shared pathological mechanisms and poor clinical outcomes of heart failure and frailty.

Main Methods:

  • Narrative review of existing literature.
  • Examination of rehabilitation strategies for heart failure and frailty.
  • Analysis of the three domains of frailty: physical, cognitive, and psychosocial.

Main Results:

  • Frailty is a critical issue in heart failure with reduced ejection fraction (HFrEF).
  • Frailty encompasses physical, cognitive, psychological, spiritual, and social aspects.
  • Nutritional and pharmacological interventions are important, requiring tailored approaches.

Conclusions:

  • Comprehensive frailty assessment is vital for risk stratification in heart failure.
  • Interventions must address multiple domains of frailty, including physical, cognitive, and social factors.
  • Multidisciplinary team-based interventions are needed to improve prognosis in heart failure patients with frailty.

Keywords:
cardiovascular diseasesfrailtyheart failurerehabilitation

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