BENEFITS OF CARDIAC REHABILITATION FOR SECONDARY PREVENTION IN HEART FAILURE: A LITERATURE REVIEW

Therapeutic Area

Heart Failure

Background

Approximately 6.7 million adults in the U.S. have a diagnosis of heart failure, with a projected prevalence of 11.4 million by 2050. These individuals experience a significant decrease in quality of life and frequent hospitalizations for acute cardiac decompensation. There is also an evident economic burden on the healthcare system due to these high rates of hospitalizations. Cardiac rehabilitation, a multidisciplinary intervention, is well-established for post-coronary revascularization procedures but remains underutilized for heart failure patients. This review evaluates its benefits based on recent U.S. based randomized controlled trials (RCTs).

Methods

A comprehensive search was conducted on PubMed to identify relevant RCTs carried out in the US and published in English between January 2020 to February 2025. The search strategy included keywords: “cardiac rehabilitation”, “exercise”, “physical activity”, “heart failure”, “HFrEF”, “HFpEF”, “congestive heart failure”, “chronic heart failure”, and “CHF”. Only studies involving adult patients (≥ 18 years of age) were included. Six studies, which directly measured the effects of cardiac rehab on patients with heart failure, were selected for this literature review.

Results

Cardiac rehabilitation significantly improved exercise capacity, peak VO2, leg strength, and quality of life compared to usual care. Reductions in arterial stiffness, myocardial stiffness, and left ventricular mass were observed. Interventions lasted 12 weeks to 1 year, with high-intensity and resistance exercises yielding better outcomes than moderate-intensity workouts. However, no significant difference was found in 6-month rehospitalization or mortality rates.

Conclusions

Cardiac rehabilitation enhances exercise tolerance and quality of life in heart failure patients, though mortality and hospitalization rates remain unchanged. Future research should explore its direct economic impact on both patients and the healthcare system and the effectiveness of cardiac rehabilitation across different stages of heart failure. Integrating cardiac rehab referrals into post-discharge and outpatient workflow may optimize heart failure patient outcomes.