It has been agreed upon that cardiac rehabilitation exercising improves the life quality of heart failure (HF) patients and their exercise capacity. However, we lack evidence of this effect on HF patients who are weak, old, and have HFpEF (heart failure with preserved ejection fraction), leading to this cohort study investigating whether outpatient CR is causal to a longer duration of survival and patient rehospitalization.
The study was performed on HF patients at 15 Japanese hospitals (2007-2016). The primary and secondary outcomes (composite of all-cause mortality and HF rehospitalization) were analyzed in outpatient CR participants compared to nonparticipants. 26% out of the 3277 patients (862) participated in outpatient CR. Then, 1592 patients with potential confounders were included, out of which 511 had composite outcomes; 14% all-cause mortality and 25% HF rehospitalizations. Hazard ratios related to CR in the composite outcome, all-cause mortality, and HF rehospitalization, were 0.77, 0.67, and 0.82, respectively. CR participation also showed a decrease in composite outcome rates in weak or HFpEF patients.
Outpatient CR contributed to a large HF group’s predictive benefit no matter the sex, age, comorbidities, weakness, and HFpEF. It was correlated with fewer risks of rehospitalization and all-cause death of HF. Both frail and HFpEF patients received no treatments to improve the outcome. This study is a foundation for standardizing CR as a treatment for HF and developing performance measures and hospitals’ guidelines to maintain this therapy.
Ref: https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.119.006798
