Cardiac Rehabilitation in Heart Failure
Keywords:
Cardiac rehabilitation, exercise, heart failure, exercise prescription, dyspnea
Abstract
Heart failure is a condition which debilitates the patient in terms of physical activity and activities of daily living. In a person with Heart Failure (HF), the heart is unable to cope up to the demands of the tissues, resulting in dyspnea. Dyspnea on performing activities of daily living, increases the fear of performing any more activities. However, recently it has been observed that exercises can be performed through a structured, supervised cardiac rehabilitation program safely and effectively. It not only improves the activity tolerance but also improves the quality of life. In this article, the benefits associated with exercise training, exercise prescription and the safety concerns during cardiac rehabilitation of heart failure patients have been discussed.
References
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4. Kokkinos PF, Choucair W, Graves P, Papademetriou V, Ellahham S. Chronic heart failure and exercise. Am Heart J.2000;140(1):21-28. doi:10.1067/mhj.2000.106916
5. Ades PA, Keteyian SJ, Balady GJ, et al. Cardiac rehabilitation exercise and self-care for chronic heart failure. JACC Heart Fail. 2013;1(6):540-547. doi:10.1016/j.jchf.2013.09.002
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8. Liu Jun-Li, Irvine Scott, Reid Ian A., Patel Kaushik P., Zucker Irving H. Chronic Exercise Reduces Sympathetic Nerve Activity in Rabbits With Pacing-Induced Heart
Failure. Circulation. 2000;102(15):1854-1862. doi:10.1161/01. CIR.102.15.1854
9. Cipriano G, Cipriano VTF, da Silva VZM, et al. Aerobic exercise effect on prognostic markers for systolic heart failure patients: a systematic review and meta-analysis. Heart Fail Rev. 2014;19(5):655-667. doi:10.1007/s10741-013-9407-6
10. Braith RW, Welsch MA, Feigenbaum MS, Kluess HA, Pepine CJ. Neuroendocrine activation in heart failure is modified by endurance exercise training. J Am Coll Cardiol. 1999;34(4):1170-1175. doi:10.1016/s0735-1097(99)00339-3
11. Hambrecht R, Niebauer J, Fiehn E, et al. Physical training in patients with stable chronic heart failure: effects on cardiorespiratory fitness and ultrastructural abnormalities of leg muscles. J Am Coll Cardiol. 1995;25(6):1239-1249. doi:10.1016/0735-1097(94)00568-B
12. Belardinelli R, Georgiou D, Cianci G, Purcaro A. Effects of exercise training on left ventricular filling at rest and during exercise in patients with ischemic cardiomyopathy and severe left ventricular systolic dysfunction. Am Heart J. 1996;132(1 Pt 1):61-70. doi:10.1016/s0002-8703(96)90391-9
13. Newhouse A, Jiang W. Heart failure and depression. Heart Fail Clin. 2014;10(2):295-304. doi:10.1016/j.hfc.2013.10.004
14. Smart N, Marwick TH. Exercise training for patients with heart failure: a systematic review of factors that improve mortality and morbidity. Am J Med. 2004;116(10):693-706. doi:10.1016/j.amjmed.2003.11.033
15. Experience from controlled trials of physical training in chronic heart failure. Protocol and patient factors in effectiveness in the improvement in exercise tolerance. European Heart Failure Training Group. Eur Heart J. 1998;19(3):466- 475. doi:10.1053/euhj.1997.0736
16. Flynn KE, Piña IL, Whellan DJ, et al. Effects of exercise training on health status in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA. 2009;301(14):1451-1459. doi:10.1001/jama.2009.457
17. Coats AJ, Adamopoulos S, Radaelli A, et al. Controlled trial of physical training in chronic heart failure. Exercise performance, hemodynamics, ventilation, and autonomic function. Circulation. 1992;85(6):2119-2131. doi:10.1161/01. cir.85.6.2119
18. Fan H, Yu W, Zhang Q, et al. Depression after heart failure and risk of cardiovascular and all-cause mortality: a meta-analysis. Prev Med. 2014;63:36-42. doi:10.1016/j. ypmed.2014.03.007
19. Blumenthal JA, Babyak MA, O’Connor C, et al. Effects of exercise training on depressive symptoms in patients with chronic heart failure: the HF-ACTION randomized trial. JAMA. 2012;308(5):465-474. doi:10.1001/jama.2012.8720
20. Pandey A, Parashar A, Kumbhani D, et al. Exercise training in patients with heart failure and preserved ejection fraction: meta-analysis of randomized control
trials. Circ Heart Fail. 2015;8(1):33-40. doi:10.1161/ CIRCHEARTFAILURE.114.001615
21. Clark AL, Poole-Wilson PA, Coats AJ. Exercise limitation in chronic heart failure: central role of the periphery. J Am Coll Cardiol. 1996;28(5):1092-1102. doi:10.1016/S0735- 1097(96)00323-3
22. Piotrowicz E, Piotrowicz R. Cardiac telerehabilitation: current situation and future challenges. Eur J Prev Cardiol. 2013;20(2 Suppl):12-16. doi:10.1177/2047487313487483c
23. Keteyian SJ, Leifer ES, Houston-Miller N, et al. Relation between Volume of Exercise and Clinical Outcomes in Patients with Heart Failure. J Am Coll Cardiol. 2012;60(19):1899-1905. doi:10.1016/j.jacc.2012.08.958.
2. Wilson JR, Martin JL, Ferraro N. Impaired skeletal muscle nutritive flow during exercise in patients with congestive heart failure: role of cardiac pump dysfunction as determined by the effect of dobutamine. Am J Cardiol. 1984;53(9):1308-1315. doi:10.1016/0002-9149(84)90085-7
3. Kugler J, Maskin C, Frishman W H, Sonnenblick E H, LeJemtel T H. Regional and systemic metabolic effects of angiotensin-converting enzyme inhibition during exercise in patients with severe heart failure. Circulation. 1982;66(6):1256-1261. doi:10.1161/01.CIR.66.6.1256
4. Kokkinos PF, Choucair W, Graves P, Papademetriou V, Ellahham S. Chronic heart failure and exercise. Am Heart J.2000;140(1):21-28. doi:10.1067/mhj.2000.106916
5. Ades PA, Keteyian SJ, Balady GJ, et al. Cardiac rehabilitation exercise and self-care for chronic heart failure. JACC Heart Fail. 2013;1(6):540-547. doi:10.1016/j.jchf.2013.09.002
6. Taylor RS, Walker S, Smart NA, et al. Impact of Exercise Rehabilitation on Exercise Capacity and Quality-of-Life in Heart Failure: Individual Participant Meta-Analysis. J Am Coll Cardiol. 2019;73(12):1430-1443. doi:10.1016/j. jacc.2018.12.072
7. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failureThe Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129-2200. doi:10.1093/eurheartj/ ehw128
8. Liu Jun-Li, Irvine Scott, Reid Ian A., Patel Kaushik P., Zucker Irving H. Chronic Exercise Reduces Sympathetic Nerve Activity in Rabbits With Pacing-Induced Heart
Failure. Circulation. 2000;102(15):1854-1862. doi:10.1161/01. CIR.102.15.1854
9. Cipriano G, Cipriano VTF, da Silva VZM, et al. Aerobic exercise effect on prognostic markers for systolic heart failure patients: a systematic review and meta-analysis. Heart Fail Rev. 2014;19(5):655-667. doi:10.1007/s10741-013-9407-6
10. Braith RW, Welsch MA, Feigenbaum MS, Kluess HA, Pepine CJ. Neuroendocrine activation in heart failure is modified by endurance exercise training. J Am Coll Cardiol. 1999;34(4):1170-1175. doi:10.1016/s0735-1097(99)00339-3
11. Hambrecht R, Niebauer J, Fiehn E, et al. Physical training in patients with stable chronic heart failure: effects on cardiorespiratory fitness and ultrastructural abnormalities of leg muscles. J Am Coll Cardiol. 1995;25(6):1239-1249. doi:10.1016/0735-1097(94)00568-B
12. Belardinelli R, Georgiou D, Cianci G, Purcaro A. Effects of exercise training on left ventricular filling at rest and during exercise in patients with ischemic cardiomyopathy and severe left ventricular systolic dysfunction. Am Heart J. 1996;132(1 Pt 1):61-70. doi:10.1016/s0002-8703(96)90391-9
13. Newhouse A, Jiang W. Heart failure and depression. Heart Fail Clin. 2014;10(2):295-304. doi:10.1016/j.hfc.2013.10.004
14. Smart N, Marwick TH. Exercise training for patients with heart failure: a systematic review of factors that improve mortality and morbidity. Am J Med. 2004;116(10):693-706. doi:10.1016/j.amjmed.2003.11.033
15. Experience from controlled trials of physical training in chronic heart failure. Protocol and patient factors in effectiveness in the improvement in exercise tolerance. European Heart Failure Training Group. Eur Heart J. 1998;19(3):466- 475. doi:10.1053/euhj.1997.0736
16. Flynn KE, Piña IL, Whellan DJ, et al. Effects of exercise training on health status in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA. 2009;301(14):1451-1459. doi:10.1001/jama.2009.457
17. Coats AJ, Adamopoulos S, Radaelli A, et al. Controlled trial of physical training in chronic heart failure. Exercise performance, hemodynamics, ventilation, and autonomic function. Circulation. 1992;85(6):2119-2131. doi:10.1161/01. cir.85.6.2119
18. Fan H, Yu W, Zhang Q, et al. Depression after heart failure and risk of cardiovascular and all-cause mortality: a meta-analysis. Prev Med. 2014;63:36-42. doi:10.1016/j. ypmed.2014.03.007
19. Blumenthal JA, Babyak MA, O’Connor C, et al. Effects of exercise training on depressive symptoms in patients with chronic heart failure: the HF-ACTION randomized trial. JAMA. 2012;308(5):465-474. doi:10.1001/jama.2012.8720
20. Pandey A, Parashar A, Kumbhani D, et al. Exercise training in patients with heart failure and preserved ejection fraction: meta-analysis of randomized control
trials. Circ Heart Fail. 2015;8(1):33-40. doi:10.1161/ CIRCHEARTFAILURE.114.001615
21. Clark AL, Poole-Wilson PA, Coats AJ. Exercise limitation in chronic heart failure: central role of the periphery. J Am Coll Cardiol. 1996;28(5):1092-1102. doi:10.1016/S0735- 1097(96)00323-3
22. Piotrowicz E, Piotrowicz R. Cardiac telerehabilitation: current situation and future challenges. Eur J Prev Cardiol. 2013;20(2 Suppl):12-16. doi:10.1177/2047487313487483c
23. Keteyian SJ, Leifer ES, Houston-Miller N, et al. Relation between Volume of Exercise and Clinical Outcomes in Patients with Heart Failure. J Am Coll Cardiol. 2012;60(19):1899-1905. doi:10.1016/j.jacc.2012.08.958.
Published
2020-09-29
How to Cite
Dr. Ankita Asher. (2020). Cardiac Rehabilitation in Heart Failure. The Indian Practitioner, 73(9), 41-45. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/1054
Section
Clinical Practice
