Effectiveness of a cardiac rehabilitation program in women with heart failure

The effectiveness of cardiac rehabilitation (CR) in improving exercise capacity and quality of life (QoL) in heart failure (HF) is well established. However, it remains underutilized in women. We aimed to compare the adherence and effectiveness of a CR program in women and men with HF.

This was a prospective single-center study of consecutive 93 HF patients referred to a CR program between September 2019 and July 2021. We defined adherence as the percentage of sessions patients attended. Effectiveness outcomes were changes in peak oxygen uptake (VO₂ peak) and QoL measurements before (baseline) and after the CR program (12wk). VO₂ peak was assessed by a maximal effort cardiopulmonary exercise testing on a treadmill. QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ).

Among 93 patients, 32.3% were female. Regarding adherence, 84% of patients completed the CR program, and no significant differences were found between groups (p=0.232). The increase in VO₂ peak did not differ between genders (p=0.938). A significant reduction in the total, physical and emotional MLHFQ scores in both genders was observed (all p<0.05). There were no significant differences in QoL effectiveness analysis between the groups (all p=NS).

Women with HF adhered to the CR program similarly to men and had a similar increase in VO₂ peak, a robust and validated prognostic marker for HF in this setting. Women benefited as much as men in all dimensions of QoL. Together, these data emphasize the need to increase the referral of women with HF to CR programs.