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Updated: Jun 3, 2025
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Evidence of Cardiac Rehabilitation for Heart Failure With Reduced Ejection Fraction in Recovery to Maintenance Phase
Naoto Miyawaki1, Akira Takashima2
1Department of Rehabilitation, Kitajima Taoka Hospital Tokushima Japan.
Insights
Cardiac rehabilitation (CR) improves exercise capacity and quality of life for patients with heart failure (HF) with reduced left ventricular ejection fraction (HFrEF). Long-term CR may also reduce mortality, with future research focusing on updated, technology-assisted programs.
Area of Science:
- Cardiology
- Rehabilitation Medicine
Background:
- Heart failure (HF) with reduced left ventricular ejection fraction (HFrEF) involves cardiac remodeling and requires comprehensive management.
- Pharmacologic therapy is primary, but cardiac rehabilitation (CR) is strongly recommended for HFrEF patients.
Purpose of the Study:
- To review the accumulating evidence on the benefits of CR for HFrEF.
- To discuss the future directions for CR in HFrEF, considering technological advancements and an aging population.
Main Methods:
- Systematic review of existing literature on CR for HFrEF.
- Analysis of CR's impact on exercise tolerance, symptoms, quality of life, rehospitalization, and mortality.
Main Results:
- CR significantly improves exercise tolerance, HF symptoms, and quality of life.
- CR reduces rehospitalization rates and may improve all-cause mortality, particularly in the long term.
- Evidence suggests CR benefits are sustained and potentially enhanced over time.
Conclusions:
- CR is a vital component of HFrEF management, offering significant benefits beyond pharmacologic treatment.
- Future CR programs for HFrEF should integrate technology and be adaptable for home-based or remote settings, especially for older adults.
- Further research is needed to optimize exercise protocols and delivery methods for evolving CR interventions.
Abstract:
Heart failure (HF) with reduced left ventricular ejection fraction (HFrEF) is typically coupled with progressive left ventricular enlargement and detrimental cardiac remodeling. The management of HFrEF is comprehensive and primarily involves pharmacologic treatment using cardioprotective agents. Cardiac rehabilitation (CR) is also strongly recommended as a treatment for HFrEF. The evidence on CR for HFrEF is accumulating. CR improves exercise tolerance, subjective symptoms caused by HF, quality of life, and rehospitalization rates. Furthermore, CR may improve all-cause mortality, although the improvement might not be evident in the short term (<1 year) but could potentially become more apparent over a longer period. In the upcoming era of super-aging and advancements in information and communications technology, CR for HFrEF will also require updating. Further research on exercise therapy will require a comprehensive evaluation of the quality and nature of exercise and whether CR would be conducted in a home-based or remote setting; these studies should include older adults, and the findings have the potential to revolutionize the field of CR.
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