Cardiac Rehabilitation in Patients with Heart Failure.
Reduced exercise capacity negatively affects the ability of patients with heart failure (HF) to perform activities required for daily life, further decreasing their independence and quality of life (QoL). Cardiac rehabilitation (CR) can effectively improve aerobic fitness and overall health status in patients with HF. Low referral rate is an important limitation that may impede successful CR, whereas the automatic referral and liaison strategies performed by some healthcare providers manifestly increase the CR referral rate. However, there is still controversy regarding the most effective exercise strategy for improving hemodynamic efficiency during daily activities in the HF population. Aerobic interval training (AIT), that includes alternating high- and low-intensity exercise sessions, may be a more effective modality for improving functional capacity than traditional moderate continuous training (MCT) in patients with HF. A novel AIT regimen designed in our previous study may substantially enhance the ability of ventilation-perfusion matching during exercise, which effects are accompanied by an improved global and disease-specific QoL in HF patients. Conversely, the traditional MCT regimen may only maintain these physiologic responses to exercise at pre-interventional status. By elucidating the relationship between physical activity and hemodynamic property, this review attempts to provide a CR strategy for developing suitable exercise prescription that ameliorates hemodynamic disturbance, further retarding the disease progression and improving health-related QoL in patients with HF.


BACKGROUND
Aerobic capacity; Heart failure; Hemodynamics; Rehabilitation.
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung; ; Heart Failure Center, Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung; ; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Tieh-Cheng
TC
Fu
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan;
Shu-Chun
SC
Huang
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung;
Chih-Chin
CC
Hsu
Heart Failure Center, Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung;
Chao-Hung
CH
Wang
Healthy Aging Research Center, Graduate Institute of Rehabilitation Science;
Jong-Shyan
JS
Wang