Cardiac Rehabilitation in Heart Failure with Reduced Ejection Fraction: Pathophysiology, Benefits and Precautions.

Heart failure (HF) is a highly comorbid condition associated with significant mortality, despite advances in current medical management. Patients suffering from HF represent a high needs disease care population in whom structured, long-term chronic disease care delivery models, such as cardiac rehabilitation (CR), have been shown to be highly cost effective in reducing hospitalizations and improving quality of life. Heart failure with reduced ejection fraction (HFrEF) is affecting a growing number of Canadians and health care costs secondary to this condition are rising, with further increases over the next decade to be expected. Cardiac rehabilitation is a guideline-directed medical therapy for patients living with HFrEF, and with increasing numbers of HF patients across the World, there is a prescient need to revisit the benefits, safety, and the prescription of this intervention for the health care professionals treating this condition. Certainly, there is a clinical need for HF practitioners to better understand the pathophysiological benefits of CR with respect to exercise training, as well as the prudent precautions required to facilitate the safe delivery of this highly cost-effective patient intervention.