Exercise training is a safe and effective guideline-recommended therapy for heart failure that improves quality of life and reduces hospitalizations, yet remains significantly underutilized due to various barriers.
Objective functional assessment and graded exercise training should be standard in heart failure; reinforces guideline-endorsed comprehensive management.
Exercise limitation is the hallmark of heart failure, and an increasing degree of intolerance is associated with poor prognosis. Objective evaluation of functional class (e.g., cardiopulmonary exercise testing) is essential for adequate prognostication in patients with advanced heart failure and for implementing an appropriate exercise training program. A graded exercise program has been shown to be beneficial in patients with heart failure and has become an essential component of comprehensive cardiac rehabilitation in these patients. An exercise program tailored to the patient's preferences, possibilities, and physiologic reserve has the greatest chance of being successful. Despite being safe, effective, and a guideline-recommended treatment to improve quality of life, exercise training remains grossly underutilized. Patient, physician, insurance and practice barriers need to be addressed to improve this quality gap.
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Álvarez et al. (2016) studied this question.
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