Exercise-based cardiac rehab confers improvements in HF
Exercise-based cardiac rehabilitation in patients with HF resulted in improvements in exercise capacity and health-related quality of life compared with patients who did not exercise, according to a study published in the Journal of the American College of Cardiology.
“These results, based on an [individual participant data] meta-analysis of randomized trials, support the class I recommendation of current international clinical guidelines that [exercise-based cardiac rehabilitation] should be offered to all HF patients and the need to improve current poor uptake of [exercise-based cardiac rehabilitation] in this population,” Rod S. Taylor, PhD, professor of health services research at University of Exeter in Glasgow, United Kingdom, and colleagues wrote.
Researchers analyzed data from 3,990 patients with HF (97% with HF with reduced ejection fraction) from 13 trials included in the ExTraMATCH individual participant data meta-analysis. Trials were included in this study if they were randomized with patients with HFrEF or preserved ejection fraction, exercise-based cardiac rehabilitation for a minimum of 3 weeks, a comparator arm that was not assigned exercise intervention, more than 50 patients and follow-up of at least 6 months. Exercise capacity and health-related quality of life data were also assessed.
Patients assigned exercise-based cardiac rehabilitation had greater improvements in exercise capacity and health-related quality of life compared with those assigned the control. At 12 months, there were improvements in Minnesota Living with HF score (mean improvement, 5.9; 95% CI, 1-10.9) and 6-minute walk test (mean, 21 m; 95% CI, 1.57-40.4).
There was no consistent interaction between the impact from exercise-based cardiac rehabilitation and predefined subgroups including ejection fraction, sex, HF etiology, NYHA functional class, ethnicity and baseline exercise capacity.
“Further data collection in this field requires a consensus on the definition, collection and reporting of core outcomes, including a defined minimum standardized set of outcomes that should be measured and reported in all clinical trials in specific areas of health or health care,” Taylor and colleagues wrote. “Additionally, we call for capture of data on patient-level adherence to exercise training during the [exercise-based cardiac rehabilitation] intervention period.” – by Darlene Dobkowski
Disclosure s : Taylor reports he is a co-chief investigator on a program granted funded by the National Institute for Health Research. Please see the study for all other authors’ relevant financial disclosures.