Long-term myocardial adaptations after cardiac rehabilitation in heart failure: a randomized six-year evaluation using magnetic resonance imaging

Abstract

Six years after participation in a concentrated residential rehabilitation programme, exercise capacity was preserved and no significant changes were observed in ventricular size or function. These findings provide further support for exercise rehabilitation in chronic heart failure.

Benefits of Cardiac Rehabilitation in Heart Failure Patients According to Etiology

“… 36 Few studies have evaluated the change of LVEF for long-term outpatient exercise rehabilitation. Although no significant improvement in LVEF was measured over several years, 14 , 21 , 37 after 5 years, trained patients were found to have higher LVEFs than controls. 14 , 37 LVEF measured in C patients remained lower than in NC patients.…”

Meta-analysis of Exercise Training on Left Ventricular Ejection Fraction in Heart Failure with Reduced Ejection Fraction: A 10-year Update

“…Compared to controls, ET was not associated with a significant change in LV end-diastolic volume (MICT, 6 trials, 8,9,11,28,30,31 n = 317; WMD: 1.85 ml; 95% CI −5.03 to 8.73 ml, I 2 = 0.0%; HIIT, 3 trials, 8,9,11 n = 235; WMD: −2.13 ml, CI −9.57 to 5.32 ml, I 2 = 0.0%; Resistance training performed alone or in combination with aerobic training, 2 trials, 14,32 n = 39, WMD: −1.24 ml; 95% CI −31.64 to 29.16, I 2 = 0.0%). No significant difference was found between HIIT and MICT for end-diastolic volume (3 trials, 8,9,11 n = 227; WMD: −4.17 ml, CI −11.08 to 2.75 ml, I 2 = 0.0%).…”

“…LV end-systolic volume did not significantly differ between MICT or resistance training performed alone or combined with aerobic training versus controls (MICT, 5 trials, 8,9,11,28,31 n = 324; WMD: −6.14 ml; 95% CI −12.83 to 0.54 ml, I 2 = 0.0%; Resistance training performed alone or in combination with aerobic training, 2 trials 14,32 ; n = 39, WMD: −6.34 ml; 95% CI −34.78 to 22.09 ml, I 2 = 0.0%). However, a significant decrease in LV end-systolic volume was found between HIIT and control (3 trials, 8,9,11 n = 235; WMD: −10.66 ml, 95% CI −17.73 to −3.58 ml, I 2 = 0.0%) but not versus MICT (3 trials, 8,9,11 n = 235; WMD: −4.77 ml, 95% CI −10.90 to 1.37 ml, I 2 = 0.0%).…”

“…8,9,11,13,14,22–34 The trials included clinically stable older (mean age: 63 years, 77% male, predominantly ischemic etiology) HFrEF patients. Fourteen trials incorporated MICT, 8,9,11,13,23–31,33 four trials compared HIIT with MICT or control, 8,9,11,26 and four trials examined the effects of resistance training performed alone or in combination with aerobic training (resistance training alone, n = 1; combined aerobic and resistance training, n = 3). 14,22,32,34 The training duration varied between 1 month and 10 years, with most of the trials lasting between 3 and 6 months.…”

“…Given heterogeneity across trials, further analysis by training length revealed that MICT performed for <6 months was associated with a modest increase in peak VO 2 (9 trials, 8,9,11,24–26,30,31,33 463 patients; WMD = 2.01 ml·kg·min −1 ; 95% CI 1.06 to 2.96 ml·kg·min −1 ; I 2 = 54.0%) while a larger increase occurred with ET ≥6 months (4 trials, 13,23,28,29 286 patients, WMD = 3.88 ml·kg·min −1 ; 95% CI 2.79 to 4.98 ml·kg·min −1 ; I 2 = 48.4%).…”