Heart failure and exercise cardiac rehabilitation in the 21^st Century

Excerpt

The first randomized trial to study the effects of exercise training in patients with heart failure was published in 1990 by Coats et al. [1], which served as a stepping off point for numerous single site trials that investigated exercise training responses in these patients [2‐6]. Subsequently, many of these trials then provided the underlying rationale for the landmark HF-ACTION trial, which was a multisite (n=2,331) study that showed that exercise was safe and, after adjustment for pre-specified covariates, resulted in mild to moderate improvement in important clinical endpoints in patients with stable heart failure with a reduced ejection fraction (HFrEF) [7]. Results from HF-ACTION and subsequent consensus Society guidelines helped result in a policy change in the United States, such that cardiac rehabilitation is now a covered service for Medicare beneficiaries with HFrEF. Around the same time, Heart Failure Reviews published a special issue that focused on exercise training principles and responses in patients with heart failure. …