Heart failure is the most negative consequence of CABG surgery (importance of exercise rehabilitation approach).

Background: Statistics indicate that approximately 25,000 open-heart surgeries are performed annually in Iran, with coronary artery bypass grafting (CABG) surgeries accounting for 50-60% of these procedures. Although CABG offers numerous benefits to patients with coronary artery disease (CAD), some cases have reported negative consequences, such as heart failure (HF).

Methods: This study explored several influential blood indices related to HF following CABG surgery using manuscripts extracted from PubMed, Scopus, and Google Scholar. The analysis focused on indicators that can exacerbate HF, including fibrotic factors such as catecholamines and the renin-angiotensin-aldosterone system (RAAS).Conversely, it also investigated anti-fibrotic factors, including adrenomedullin (ADM), the natriuretic peptide system (NPS), NP-converting enzymes, and NP receptors. Additionally, the study evaluated the impact of various exercise training programs on these variables.

Results: Some fibrotic factors, such as catecholamines and the RAAS, contrast with anti-fibrosis factors, including NPs, their producing enzymes, receptors, production and excretion processes, ADM, and others. Research suggests these elements can be positively influenced by exercise rehabilitation.This study highlights the beneficial effects of exercise rehabilitation, specifically in reducing fibrotic factors and enhancing anti-fibrosis factors.

Conclusion: All types of exercise training-including endurance, resistance, and combined training, in both continuous and interval modes with moderate and high intensity-can delay fibrotic pathways after surgery and prevent subsequent adverse structural (pathologic hypertrophy) and functional changes in the heart, such as HF.