What is the clinical evidence from this study?

Study design: Observational. Population: Adults with cardiovascular disease participating in a cardiac rehabilitation program including heart failure, acute coronary syndrome, chronic coronary syndrome, post-cardiac surgery, and dyspnea with multiple comorbidities (n=95). Intervention: Cardiac rehabilitation program involving aerobic and resistance exercise, inspiratory muscle training, and therapy titration vs. Baseline/pre cardiac rehabilitation status. Primary outcome: Functional capacity improvement assessed by 6 min walk test (6MWT) meters covered (p < 0.0001, p=<0.0001).

What does this research mean for the field?

Cardiac rehabilitation significantly improves functional capacity in patients with cardiovascular disease, as evidenced by a 23% increase in the 6-minute walk test distance, and increases the usage of SGLT2i therapy from 22% to 34%. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

The study aims to analyze the characteristics and therapy changes of patients participating in cardiac rehabilitation.

February 12, 2026Open Access

Analysis of a Real-World Population Participating in a Cardiac Rehabilitation Program: Cognitive Impairment, Functional Capacity, and Therapy Titration

Q: What are the key findings of this study?

Cardiac rehabilitation improved 6MWT distance by 73 m (+23.6%) from 306.0 m to 378.9 m (p < 0.0001) in cardiovascular patients with multiple comorbidities.

Q: What does this research mean for the field?

Cardiac rehabilitation significantly improves functional capacity in patients with cardiovascular disease, as evidenced by a 23% increase in the 6-minute walk test distance, and increases the usage of SGLT2i therapy from 22% to 34%. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Q: What question did this study set out to answer?

The study aims to analyze the characteristics and therapy changes of patients participating in cardiac rehabilitation.

Key Result

Cardiac rehabilitation improved 6MWT distance by 73 m (+23.6%) from 306.0 m to 378.9 m (p < 0.0001) in cardiovascular patients with multiple comorbidities.

Key Points

The study aims to analyze the characteristics and therapy changes of patients participating in cardiac rehabilitation.
Analyzed anthropometric, clinical, laboratory, and instrumental data of 95 patients enrolled in CR
Conducted cardiopulmonary exercise tests to assess functional capacity
Performed 6-minute walk tests pre- and post-CR
Monitored changes in cardiovascular therapy, particularly drug titration
Patients showed moderately reduced functional capacity at baseline with VO2 peak of 14.29 mL/min/kg
Significant improvement in 6MWT from 306.02 m to 378.88 m post-CR (p < 0.05)
22% of patients were identified with mild cognitive impairment (Qmci score < 49.4 points)
Increased use of SGLT2i therapy pre- to post-CR from 22% to 34% (p < 0.05)

Study Design

Type

Observational (n=95)

Multicenter

Structured PICO

Does a cardiac rehabilitation program improve functional capacity and optimize medical therapy in patients with cardiovascular disease?

Population

95 patients (age 66.56 ± 0.99 years, 75% male) with various cardiovascular diagnoses (17% heart failure, 18% cardiac surgery, 20% acute coronary syndrome, 16% chronic coronary syndrome, 29% dyspnea) enrolled in a cardiac rehabilitation program in Salerno, Italy between 2023 and 2025.

Intervention

Cardiac rehabilitation (CR) program

Outcome

Functional capacity (6-minute walk test), cognitive assessment, and therapeutic changes (drug titration)surrogate

Cardiac rehabilitation in a real-world setting significantly improves functional capacity and facilitates the optimization of guideline-directed medical therapy, such as SGLT2 inhibitors.

Main Result

Effect estimate: p < 0.0001

Absolute Event Rate: 378.88% vs 306.02%

p-value: p=<0.0001

Limitations

Small sample size
No post-CR cognitive assessment data
Only 19 patients had complete pre- and post-CR CPET data

Abstract

Background: Cardiac rehabilitation (CR) is a fundamental pillar in the therapeutic pathway of patients with cardiovascular disease, contributing significantly to improving quality of life and reducing the risk of cardiovascular event recurrence. Over the past decades, this approach has progressively evolved, integrating multidisciplinary strategies based on scientific evidence. This study aimed to conduct a detailed analysis of the anthropometric, clinical, and functional characteristics of patients enrolled in the CR Unit of the San Giovanni di Dio and Ruggi D’Aragona University Hospital in Salerno, with particular attention to therapeutic changes, drug titration, and cognitive assessment. Methods: Specifically, the anthropometric, clinical, laboratory, and instrumental data of 95 patients (age 66.56 ± 0.99 years, 75% male) who underwent the CR program between 2023 and 2025 were analyzed. Results: Patients with various diagnoses were enrolled in the CR program: 17% heart failure, 18% cardiac surgery, 20% acute coronary syndrome, 16% chronic coronary syndrome, 29% dyspnea. The patients had numerous comorbidities and risk factors: 73% arterial hypertension, 77% dyslipidemia, 35% diabetes mellitus, 33% smoking, 13% thyroid dysfunction, 47% CAD, 18% CKD, 16% COPD. At baseline, Cardiopulmonary exercise test (CPET) showed a moderately reduced functional capacity (VO2 peak pre-CR: 14.29 ± 0.53 mL/min/kg; VO2% predicted pre-CR: 62.19 ± 2.43%), and a significant improvement was recorded in meters at 6 min walk test (6MWT) post-CR (pre-CR: 306.02 ± 9.93 m vs. post-CR: 378.88 ± 13.37 m; p < 0.05). Notably, 22% of patients had a Qmci score < 49.4 points, indicating an MCI. Finally, the cardiovascular therapy was titrated and adapted; specifically, we recorded a significant increase in the use of SGLT2i therapy (pre-RC 22.00% vs. post-RC 34.00%; p < 0.05). Conclusions: In conclusion, CR proved to be safe and effective in enrolled patients; further studies will be needed to investigate the therapeutic modifications implemented during CR programs in more detail.

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