Heart Failure as a Newly Approved Diagnosis for Cardiac Rehabilitation: Challenges and Opportunities

Many see the broadened eligibility of cardiac rehabilitation (CR) to include heart failure with reduced ejection fraction (HFrEF) as a likely catalyst to high CR enrollment and improved care. However, such expectation contrasts with the reality that CR enrollment of eligible coronary heart disease p...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2015-06, Vol.65 (24), p.2652-2659
Main Authors: Forman, Daniel E, Sanderson, Bonnie K, Josephson, Richard A, Raikhelkar, Jayant, Bittner, Vera
Format: Article
Language:English
Subjects:
Animals
Clinical Trials as Topic - methods
Disease Management
Exercise Therapy - methods
Exercise Therapy - trends
Heart Failure - diagnosis
Heart Failure - epidemiology
Heart Failure - rehabilitation
Humans
Stroke Volume - physiology
Treatment Outcome
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Summary:Many see the broadened eligibility of cardiac rehabilitation (CR) to include heart failure with reduced ejection fraction (HFrEF) as a likely catalyst to high CR enrollment and improved care. However, such expectation contrasts with the reality that CR enrollment of eligible coronary heart disease patients has remained low for decades. In this review, entrenched obstacles impeding utilization of CR are considered, particularly in relation to potential HFrEF management. The strengths and limitations of the HF-ACTION (Heart Failure-A Controlled Trial Investigating Outcomes of Exercise Training) trial to advance precepts of CR are considered, as well as gaps that this trial failed to address, such as the utility of CR for patients with heart failure with preserved ejection fraction and the conundrum of poor patient adherence.
ISSN:1558-3597
DOI:10.1016/j.jacc.2015.04.052