Effects of Acute Phase Intensive Exercise Training in Patients With Acute Decompensated Heart Failure.

Area of Science:

• Cardiology
• Geriatrics
• Rehabilitation Medicine

Background:

• Acute decompensated heart failure (ADHF) causes hospitalizations and functional decline in older adults.
• Cardiac rehabilitation (CR) benefits stable heart failure patients, but its role in ADHF, especially in non-frail individuals, is not well-defined.

Purpose of the Study:

• To assess the efficacy and safety of early in-hospital CR for non-frail patients hospitalized with ADHF.
• To evaluate the impact of structured exercise training and early mobilization on recovery.

Main Methods:

• A multicenter trial randomized 91 non-frail ADHF patients (2:1) to early CR or standard care.
• The CR group received early mobilization and structured exercise.
• Primary outcome: change in 6-minute walk distance (6MWD) from baseline to discharge.

Main Results:

• The CR group showed a significantly greater improvement in 6MWD (75.0 m) compared to the control group (44.1 m).
• Secondary outcomes indicated improvements in physical/cognitive function, physical activity, and quality of life.
• Safety profiles were similar, with a notable reduction in B-type natriuretic peptide in the CR group at 90 days.

Conclusions:

• Early in-hospital CR significantly improves 6MWD in non-frail ADHF patients within two weeks post-randomization.
• The intervention is safe and enhances functional recovery and quality of life without adverse events.