Evidence of Cardiac Rehabilitation for Heart Failure With Reduced Ejection Fraction in Recovery to Maintenance Phase

Heart failure (HF) with reduced left ventricular ejection fraction (HFrEF) is typically coupled with progressive left ventricular enlargement and detrimental cardiac remodeling. The management of HFrEF is comprehensive and primarily involves pharmacologic treatment using cardioprotective agents. Cardiac rehabilitation (CR) is also strongly recommended as a treatment for HFrEF. The evidence on CR for HFrEF is accumulating. CR improves exercise tolerance, subjective symptoms caused by HF, quality of life, and rehospitalization rates. Furthermore, CR may improve all-cause mortality, although the improvement might not be evident in the short term (<1 year) but could potentially become more apparent over a longer period. In the upcoming era of super-aging and advancements in information and communications technology, CR for HFrEF will also require updating. Further research on exercise therapy will require a comprehensive evaluation of the quality and nature of exercise and whether CR would be conducted in a home-based or remote setting; these studies should include older adults, and the findings have the potential to revolutionize the field of CR.