title: Benefits of cardiac rehabilitation in heart failure patients according to etiology: INCARD French study.
abstract: We investigated the impact of heart failure (HF) etiology on the outcome of cardiac rehabilitation (CR) assessed by functional and clinical parameters. Treatment of chronic HF requires multidisciplinary approaches with a recognized role for CR. INCARD is a French study aimed at evaluating the benefits of sustainable CR in coronary (C) and noncoronary patients (NC) treated and educated during a 24-month period of follow-up. Prospective, monocentric patients with HF underwent inpatient physical training followed by a home-based program. Evaluations were performed at inclusion, discharge, 3 months after discharge, and subsequently every 6 months over the 24 months of outpatient rehabilitation.A total of 147 HF patients with left ventricular ejection fraction (LVEF) <40 were admitted to the CR center, 63 accepted to join INCARD (29 C and 34 NC). Although the C participants C having both an echocardiographic LVEF and an initially lower peak VO2, inpatient rehabilitation improved all functional parameters. Only NC showed an improved LVEF during the first 3 months of outpatient-follow-up. The main outcome of the outpatient rehabilitation was a trend toward stabilization of clinical and laboratory parameters with no significant difference between C and NC. This study confirms the benefits of initial HF inpatient rehabilitation and encourages prolonged outpatient monitoring. The results on functional parameters suggest exercise training should be conducted regardless of the HF etiology.
authors.affiliation: From the INSERM I2MC, UMR 1048, Université UPS, Equipe «Obésité et insuffisance cardiaque: approches moléculaires et cliniques », Toulouse (FK, FD, MG, FS, PR); Service de Réadaptation Cardiaque Centre Hospitalier Sud Francilien, 116 Boulevard Jean Jaurès, Corbeil-Essonnes, (FK, GL, DB, LB); and Cardiology Department, Rangueil Hospital University, Toulouse, France (MG).
authors.forename: François
authors.initials: F
authors.lastname: Koukoui
authors.forename: Franck
authors.initials: F
authors.lastname: Desmoulin
authors.forename: Gérard
authors.initials: G
authors.lastname: Lairy
authors.forename: Dominique
authors.initials: D
authors.lastname: Bleinc
authors.forename: Ludovic
authors.initials: L
authors.lastname: Boursiquot
authors.forename: Michel
authors.initials: M
authors.lastname: Galinier
authors.forename: Fatima
authors.initials: F
authors.lastname: Smih
authors.forename: Philippe
authors.initials: P
authors.lastname: Rouet
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002908:Chronic Disease; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000534:rehabilitation*; D006334:Heart Function Tests; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D002317:Cardiovascular Agents