Exercise based cardiac rehabilitation reduces hospitalizations in heart failure patients

Delhi: Exercise based cardiac rehabilitation (ExCR) appears to be beneficial for heart failure (HF) patients in terms of reducing hospitalizations and improving health-related quality of life (HRQoL), according to a review.

The study, published in the journal JACC: Heart Failure, however also found that ExCR does not appear to reduce or increase mortality compared with no-exercise controls.

Chronic heart failure is a major health issue affecting 1% to 2% of people in the Western world. Although survival after HF diagnosis has improved, prognosis remains poor resulting in deaths of 30% to 40% of the patients within 1 year of diagnosis. HF patients experience marked reductions in their exercise capacity which has detrimental effects on their daily activities and HRQoL.

There is an increasing call for trials of models of ExCR for patients with HF that provide alternatives to conventional centre-based provision and recruitment of patients that reflect a broader HF population.

Rod S. Taylor, University of Exeter College of Medicine and Health, Exeter, United Kingdom, and colleagues performed a contemporary systematic review and meta-analysis of exercise-based cardiac rehabilitation for heart failure.

The researchers searched for online databases between January 2013 and January 2018. Randomized trials comparing patients undergoing ExCR to control patients not undergoing exercise were included. 44 RCTs involving 5,783 patients were included.

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Key findings include:

• ExCR did not reduce the risk of all-cause mortality but did reduce all-cause hospitalization and HF-specific hospitalization, and patients reported improved Minnesota Living with Heart Failure questionnaire overall scores.


• No evidence of differential effects across different models of delivery, including centre- versus home-based programs, were found.

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"This review supports the beneficial effects of ExCR on patient outcomes. These benefits appear to be consistent across ExCR program characteristics. GRADE and TSA assessments indicated that further high-quality randomized trials are needed," concluded the authors.

To reads the complete study follow the link: DOI: 10.1016/j.jchf.2019.04.023