|
1
|
Bozkurt B, Fonarow GC, Goldberg LR, Guglin M, Josephson RA, Forman DE, Lin G, Lindenfeld J, O'Connor C, Panjrath G, Piña IL, Shah T, Sinha SS, Wolfel E. Cardiac Rehabilitation for Patients With Heart Failure: JACC Expert Panel. J Am Coll Cardiol 2021; 77:1454-1469. [PMID: 33736829 DOI: 10.1016/j.jacc.2021.01.030] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/23/2020] [Accepted: 01/04/2021] [Indexed: 02/07/2023]
Abstract
Cardiac rehabilitation is defined as a multidisciplinary program that includes exercise training, cardiac risk factor modification, psychosocial assessment, and outcomes assessment. Exercise training and other components of cardiac rehabilitation (CR) are safe and beneficial and result in significant improvements in quality of life, functional capacity, exercise performance, and heart failure (HF)-related hospitalizations in patients with HF. Despite outcome benefits, cost-effectiveness, and strong practice guideline recommendations, CR remains underused. Clinicians, health care leaders, and payers should prioritize incorporating CR as part of the standard of care for patients with HF.
Collapse
Affiliation(s)
- Biykem Bozkurt
- Winters Center for Heart Failure, Cardiovascular Research Institute, Baylor College of Medicine and DeBakey VA Medical Center, Houston, Texas, USA.
| | - Gregg C Fonarow
- Ahmanson-UCLA Cardiomyopathy Center, Division of Cardiology, University of California-Los Angeles, Los Angeles, California, USA
| | - Lee R Goldberg
- Cardiovascular Division, Perelman School of Medicine at the, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Maya Guglin
- Indiana University School of Medicine, Krannert Institute of Cardiology, Indianapolis, Indiana, USA
| | - Richard A Josephson
- Cardiovascular and Pulmonary Rehabilitation, Harrington Heart & Vascular Institute, Case Western Reserve University, Division of Cardiovascular Medicine, University Hospitals Health System, Cleveland, Ohio, USA
| | - Daniel E Forman
- Divisions of Cardiology and Geriatrics, University of Pittsburgh and VA Pittsburgh Health Care System, Pittsburgh, Pennsylvania, USA
| | - Grace Lin
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - JoAnn Lindenfeld
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Chris O'Connor
- Inova Heart and Vascular Institute, Inova Fairfax Medical Center, Falls Church, Virginia, USA; Duke University, Durham, North Carolina, USA
| | - Gurusher Panjrath
- Division of Cardiology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Ileana L Piña
- Wayne State University, Detroit, Michigan, USA; Central Michigan University, Mt. Pleasant, Michigan, USA
| | - Tina Shah
- Department of Cardiology, Kaiser Permanente Washington, Seattle, Washington, USA
| | - Shashank S Sinha
- Inova Heart and Vascular Institute, Inova Fairfax Medical Center, Falls Church, Virginia, USA; Duke University, Durham, North Carolina, USA
| | - Eugene Wolfel
- Section of Advanced Heart Failure and Transplant Cardiology, Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | | |
Collapse
|
|
3
|
Holloway TM, Spriet LL. CrossTalk opposing view: High intensity interval training does not have a role in risk reduction or treatment of disease. J Physiol 2015; 593:5219-21. [PMID: 26641011 DOI: 10.1113/jp271039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/02/2015] [Indexed: 01/02/2023] Open
Affiliation(s)
- Tanya M Holloway
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Lawrence L Spriet
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| |
Collapse
|
|
4
|
Arena R, Lavie CJ, Borghi-Silva A, Daugherty J, Bond S, Phillips SA, Guazzi M. Exercise Training in Group 2 Pulmonary Hypertension: Which Intensity and What Modality. Prog Cardiovasc Dis 2015; 59:87-94. [PMID: 26569571 DOI: 10.1016/j.pcad.2015.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 11/09/2015] [Indexed: 12/29/2022]
Abstract
Pulmonary hypertension (PH) due to left-sided heart disease (LSHD) is a common and disconcerting occurrence. For example, both heart failure (HF) with preserved and reduced ejection fraction (HFpEF and HFrEF) often lead to PH as a consequence of a chronic elevation in left atrial filling pressure. A wealth of literature demonstrates the value of exercise training (ET) in patients with LSHD, which is particularly robust in patients with HFrEF and growing in patients with HFpEF. While the effects of ET have not been specifically explored in the LSHD-PH phenotype (i.e., composite pathophysiologic characteristics of patients in this advanced disease state), the overall body of evidence supports clinical application in this subgroup. Moderate intensity aerobic ET significantly improves peak oxygen consumption, quality of life and prognosis in patients with HF. Resistance ET significantly improves muscle strength and endurance in patients with HF, which further enhance functional capacity. When warranted, inspiratory muscle training and neuromuscular electrical stimulation are becoming recognized as important components of a comprehensive rehabilitation program. This review will provide a detailed account of ET programing considerations in patients with LSHD with a particular focus on those concomitantly diagnosed with PH.
Collapse
Affiliation(s)
- Ross Arena
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA.
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School - The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil
| | - John Daugherty
- Department of Biomedical and Health Information Sciences, College of Applied Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Samantha Bond
- Department of Biomedical and Health Information Sciences, College of Applied Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Shane A Phillips
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Marco Guazzi
- Cardiology, I.R.C.C.S. Policlinico San Donato, University of Milano, San Donato Milanese, Milano, Italy
| |
Collapse
|
|
5
|
Arena R, Lavie CJ, Cahalin LP, Briggs PD, Guizilini S, Daugherty J, Chan WM, Borghi-Silva A. Transforming cardiac rehabilitation into broad-based healthy lifestyle programs to combat noncommunicable disease. Expert Rev Cardiovasc Ther 2015; 14:23-36. [DOI: 10.1586/14779072.2016.1107475] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|