Exercise‐based cardiac rehabilitation for adults with heart failure – 2023 Cochrane systematic review and meta‐analysis

Molloy, Cal D.; Long, Linda; Mordi, Ify R.; Bridges, Charlene; Sagar, Viral A.; Davies, Edward J.; Coats, Andrew J.S.; Dalal, Hasnain; Rees, Karen; Singh, Sally J.; Taylor, Rod S.

doi:10.1002/ejhf.3046

Cited by 7 publications

(2 citation statements)

References 61 publications

(106 reference statements)

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“…In Japan, CR, with a focus on exercise therapy, has shown positive outcomes such as improved mortality rates [14,16] , reduced risk of HF rehospitalization [16] and all rehospitalization [17] , and enhanced quality of life for individuals with chronic HFrEF. Similarly, for patients with HFpEF, exercise therapy has been proven to enhance their quality of life and is associated with a better long-term prognosis [16,18] .…”

Section: Cr In the Guideline Of The Japanese Circulation Societymentioning

confidence: 99%

Physical activity and cardiac rehabilitation for the primary and secondary prevention of heart failure

Komuro,

Ueno

et al. 2024

Cardiology Plus

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Heart failure (HF) is a mounting global health and financial concern. With the introduction of angiotensin receptor-neprilysin inhibitors and sodium-glucose cotransporter-2 inhibitors, outcomes for HF have improved dramatically in recent years, however, the increase in HF cases remains uncontrolled, and reliance on current medical treatment alone is no longer sufficient. Therefore, primary prevention through exercise habits and secondary prevention through cardiac rehabilitation (CR) are becoming increasingly important to reduce the number of HF cases. We have previously highlighted the benefits of adopting a healthy lifestyle in preventing cardiovascular disease (CVD), even in individuals with cancer. Our findings underscore the importance of incorporating regular exercise into lifestyle modification and highlight the critical role of exercise habits in primary prevention, especially in terms of CVD prevention. The importance of CR is emphasized in the many guidelines such as European, American, and Japanese guidelines. CR is given a Class I recommendation due to its association with improved prognosis for patients with HF. Furthermore, early initiation of CR is recommended, especially for older patients with HF, because CR has been reported to reduce the length of stay and prevent rehospitalization. In addition to the existing evidence, the Nationwide Population-Based Database in Japan has indicated the importance of CR in patients with acute HF and of enhancing gait speed in preventing HF. Although the importance of CR is recognized worldwide, actual utilization of CR by patients remains low. The challenge for the future is to raise awareness among attending physicians and patients about the importance of exercise habits and CR by actively promoting individualized rehabilitation.

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Section: Cr In the Guideline Of The Japanese Circulation Societymentioning

confidence: 99%

Physical activity and cardiac rehabilitation for the primary and secondary prevention of heart failure

Komuro,

Ueno

et al. 2024

Cardiology Plus

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“…31 A Cochrane systematic review and meta-analysis including 60 trials (8728 participants) did not show a significant impact of exercise-based cardiac rehabilitation on all-cause deaths with, however, a reduction in all-cause hospitalization and an improvement of quality of life. 32…”

Section: Exercise Trainingmentioning

confidence: 99%

December 2023 at a glance: Focus on medical therapy in chronic and acute heart failure

Tomasoni,

Adamo,

Metra

2023

European J of Heart Fail

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Acute HF is still associated with poor prognosis and efforts are needed to improve its prognosis. 21,22 A pre-defined sex-specific analysis of the GALACTIC (Goal directed afterload reduction acute congestive cardiac decompensation study) trial showed that a strategy of early intensive and sustained vasodilatation with rapid up-titration of renin-angiotensin-aldosterone system (RAAS) inhibitors versus usual care was less successful in women versus men both in the overall cohort and in patients with HFrEF. 23 In a previous analysis no significant treatment-by-sex interactions were found in the STRONG-HF trial. 24 Implementation of GDMT affects kidney function. 8 An analysis of STRONG-HF described the association between changes in renal function and efficacy of rapid up-titration of GDMT according to the high-intensity care (HIC) strategy. The HIC group had less HF readmissions or death regardless of baseline eGFR at 180 days. An early decrease in eGFR at 1 week was associated with

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2024 update in heart failure

Beghini,

Sammartino,

Papp

et al. 2024

ESC Heart Failure

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In the last years, major progress has occurred in heart failure (HF) management. The 2023 ESC focused update of the 2021 HF guidelines introduced new key recommendations based on the results of the last years of science. First, two drugs, sodium–glucose co‐transporter‐2 (SGLT2) inhibitors and finerenone, a novel nonsteroidal, selective mineralocorticoid receptor antagonist (MRA), are recommended for the prevention of HF in patients with diabetic chronic kidney disease (CKD). Second, SGLT2 inhibitors are now recommended for the treatment of HF across the entire left ventricular ejection fraction spectrum. The benefits of quadruple therapy in patients with HF with reduced ejection fraction (HFrEF) are well established. Its rapid and early up‐titration along with a close follow‐up with frequent clinical and laboratory re‐assessment after an episode of acute HF (the so‐called ‘high‐intensity care’ strategy) was associated with better outcomes in the STRONG‐HF trial. Patients experiencing an episode of worsening HF might require a fifth drug, vericiguat. In the STEP‐HFpEF‐DM and STEP‐HFpEF trials, semaglutide 2.4 mg once weekly administered for 1 year decreased body weight and significantly improved quality of life and the 6 min walk distance in obese patients with HF with preserved ejection fraction (HFpEF) with or without a history of diabetes. Further data on safety and efficacy, including also hard endpoints, are needed to support the addition of acetazolamide or hydrochlorothiazide to a standard diuretic regimen in patients hospitalized due to acute HF. In the meantime, PUSH‐AHF supported the use of natriuresis‐guided diuretic therapy. Further options and most recent evidence for the treatment of HF, including specific drugs for cardiomyopathies (i.e., mavacamten in hypertrophic cardiomyopathy and tafamidis in transthyretin cardiac amyloidosis), device therapies, cardiac contractility modulation and percutaneous treatment of valvulopathies, with the recent finding from the TRILUMINATE Pivotal trial, are also reviewed in this article.

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Exercise‐based cardiac rehabilitation for adults with heart failure – 2023 Cochrane systematic review and meta‐analysis

Cited by 7 publications

References 61 publications

Physical activity and cardiac rehabilitation for the primary and secondary prevention of heart failure

Physical activity and cardiac rehabilitation for the primary and secondary prevention of heart failure

December 2023 at a glance: Focus on medical therapy in chronic and acute heart failure

2024 update in heart failure

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