Physical Training and Cardiac Rehabilitation in Heart Failure Patients

Abstract

Regardless of advances in medical and interventional treatment of cardiovascular disease (CVD), a limited number of patients attend a cardiac rehabilitation (CR) programme on a regular basis. Due to modern therapies more individuals will be surviving an acute cardiovascular event, but the expected burden of chronic heart failure will be increasing worldwide.However, both in high- and low-income countries, secondary prevention after an acute myocardial infarction or stroke has been implemented in less than a half of eligible patients.Combined interventions are still needed to reduce decompensations, hospitalizations and mortality in heart failure patients from any origin. In addition to medical treatments, regular exercise has been demonstrated to improve metabolic and hemodynamic conditions in both asymptomatic risk factor carriers and cardiac patients. Risk factor control and exercise should gather together for an effective management of patients.Exercise-based training is a core component of primary and secondary prevention. It should involve healthy carriers of cardiovascular risk factors, and patients with cardiomyopathy as well. The supposed attenuated effect of CR in the era of advanced revascularization and structural interventions is due to the heterogeneity of training models and physical training in the literature. Moreover, lifestyle modification, psycho-social challenges and patient's compliance are potential confounders.In this chapter the most recent evidences about training modalities and potential benefit of CR in heart failure patients are discussed.

Effect of cardiac rehabilitation training on patients with coronary heart disease: a systematic review and meta-analysis

“…To improve the reliability of the research, an expanded sample size is needed in the future. As the incidence of heart disease increases in middle-aged and elderly people, CVD has become the main cause of death (18) CHD, but also significantly improves the quality of life of patients (5). Through the meta-analysis of the original data of the 8 studies, we found that HIIT can improve the patient's cardiac function and prognosis.…”

“…Cardiac rehabilitation training accelerates blood circulation, improves myocardial support capacity, promotes cardiac rehabilitation, and reduces the risk of disability and death. Many studies have confirmed that cardiac rehabilitation is safe and effective (5). However, it has not been fully utilized in clinical work.…”

Controversial Impact of Sirtuins in Chronic Non-Transmissible Diseases and Rehabilitation Medicine

“…Of the 56.4 million estimated worldwide deaths in 2015, about 54% occurred in consequence of cardiovascular diseases (CVD) [ 46 ]. In this context, it has been clearly shown that physical activity and a healthy lifestyle significantly decrease the risk of CVDs and their worsening [ 47 ]. Accordingly, a large number of cardiac rehabilitation (CR) programs have been developed to treat CVDs in an attempt of preventing secondary events.…”

Controversial Impact of Sirtuins in Chronic Non-Transmissible Diseases and Rehabilitation Medicine

“…Of the 56.4 million deaths worldwide in 2015, 54% were due to cardiovascular diseases (CVD) [45]. In this context, it has been clearly shown that physical activity and a healthy lifestyle significantly decrease the risk of CVDs and their worsening [46]. Accordingly, a large number of cardiac rehabilitation (CR) programs has been developed to treat CVDs attempting to prevent secondary events.…”