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Cardiac rehabilitation in heart failure with severely reduced ejection fraction: effects on mortality

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Abstract

Thirty years ago, patients with low ejection fraction (EF) have often been excluded from rehabilitation programs due to concern about possibility of sudden death or other adverse cardiovascular events during exercise sessions. Recent studies have highlighted the fact that cardiac rehabilitation could improve exercise capacity, cardiac function, and health-related quality of life in congestive heart failure patients. This encouraged us to write a review article and update our latest knowledge about the outcome of rehabilitation program in patients with severely depressed cardiac function. We were particularly interested in effect of cardiac rehabilitation on exercise capacity, quality of life, vascular effects, neuro-hormonal changes, and mortality. We also conducted a mini-systematic review and meta-analysis on randomized controlled trials comparing exercise training with usual care in patients with severely reduced left ventricular ejection fraction, for the mortality subsection to obtain precise estimates of overall treatment benefit on mortality. It is our privilege to submit our manuscript for possible publication in your prestigious journal.

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References

  1. Quittan M, Sturm B, Wiesinger GF, Pacher R, Fialka-Moser V (1999) Quality of life in patients with chronic heart failure: a randomized controlled trial of changes induced by a regular exercise program. Scand J Rehabil Med 31(4):223–228

    Article  CAS  Google Scholar 

  2. Schopfer DW, Forman DE (2016) Growing relevance of cardiac rehabilitation for an older population with heart failure. J Card Fail 22(12):1015–1022

    Article  Google Scholar 

  3. Writing Group M, Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ et al (2016) Heart disease and stroke statistics-2016 update: a report from the American heart association. Circulation 133(4):e38-360

    Google Scholar 

  4. Keteyian SJ (2011) Exercise training in congestive heart failure: risks and benefits. Prog Cardiovasc Dis 53(6):419–428

    Article  Google Scholar 

  5. Squires RW, Lavie CJ, Brandt TR, Gau GT, Bailey KR (1987) Cardiac rehabilitation in patients with severe ischemic left ventricular dysfunction. Mayo Clin Proc 62(11):997–1002

    Article  CAS  Google Scholar 

  6. Coats AJ, Adamopoulos S, Meyer TE, Conway J, Sleight P (1990) Effects of physical training in chronic heart failure. Lancet 335(8681):63–66

    Article  CAS  Google Scholar 

  7. Guo R, Wen Y, Xu Y, Jia R, Zou S, Lu S et al (2021) The impact of exercise training for chronic heart failure patients with cardiac resynchronization therapy: a systematic review and meta-analysis. Medicine (Baltimore) 100(13):e25128

  8. Kono M, Kisanuki A, Takasaki K, Nakashiki K, Yuasa T, Kuwahara E et al (2009) Left ventricular systolic function is abnormal in diastolic heart failure: re-assessment of systolic function using cardiac time interval analysis. J Cardiol 53(3):437–446

    Article  Google Scholar 

  9. Sullivan MJ, Higginbotham MB, Cobb FR (1988) Exercise training in patients with severe left ventricular dysfunction. Hemodynamic and metabolic effects. Circulation 78(3):506–515

    Article  CAS  Google Scholar 

  10. Port S, McEwan P, Cobb FR, Jones RH (1981) Influence of resting left ventricular function on the left ventricular response to exercise in patients with coronary artery disease. Circulation 63(4):856–863

    Article  CAS  Google Scholar 

  11. Hollriegel R, Winzer EB, Linke A, Adams V, Mangner N, Sandri M et al (2016) Long-term exercise training in patients with advanced chronic heart failure: sustained benefits on left ventricular performance and exercise capacity. J Cardiopulm Rehabil Prev 36(2):117–124

    Article  Google Scholar 

  12. Besnier F, Labrunée M, Richard L, Faggianelli F, Kerros H, Soukarié L et al (2019) Short-term effects of a 3-week interval training program on heart rate variability in chronic heart failure. A randomised controlled trial. Ann Phys Rehabil Med 62(5):321–8

  13. Meyer K, Samek L, Schwaibold M, Westbrook S, Hajric R, Beneke R et al (1997) Interval training in patients with severe chronic heart failure: analysis and recommendations for exercise procedures. Med Sci Sports Exerc 29(3):306–312

    Article  CAS  Google Scholar 

  14. Erbs S, Hollriegel R, Linke A, Beck EB, Adams V, Gielen S et al (2010) Exercise training in patients with advanced chronic heart failure (NYHA IIIb) promotes restoration of peripheral vasomotor function, induction of endogenous regeneration, and improvement of left ventricular function. Circ Heart Fail 3(4):486–494

    Article  Google Scholar 

  15. Factor SM, Flomenbaum M, Zhao MJ, Eng C, Robinson TF (1988) The effects of acutely increased ventricular cavity pressure on intrinsic myocardial connective tissue. J Am Coll Cardiol 12(6):1582–1589

    Article  CAS  Google Scholar 

  16. Demopoulos L, Bijou R, Fergus I, Jones M, Strom J, LeJemtel TH (1997) Exercise training in patients with severe congestive heart failure: enhancing peak aerobic capacity while minimizing the increase in ventricular wall stress. J Am Coll Cardiol 29(3):597–603

    Article  CAS  Google Scholar 

  17. Pathak A, Curnier D, Fourcade J, Roncalli J, Stein PK, Hermant P et al (2005) QT dynamicity: a prognostic factor for sudden cardiac death in chronic heart failure. Eur J Heart Fail 7(2):269–275

    Article  Google Scholar 

  18. Caru M, Gravel H, Pathak A, Bousquet M, Galinier M, Jacquemet V et al (2020) Observations on changes in ventricular repolarization following four weeks of exercise training in chronic heart failure patients. Scand Cardiovasc J : SCJ 54(6):369–375

    Article  Google Scholar 

  19. Kusunose K, Seno H, Yamada H, Nishio S, Torii Y, Hirata Y et al (2018) Right ventricular function and beneficial effects of cardiac rehabilitation in patients with systolic chronic heart failure. Can J Cardiol 34(10):1307–1315

    Article  Google Scholar 

  20. Tanaka S, Sanuki Y, Ozumi K, Harada T, Tasaki H (2018) Heart failure with preserved vs reduced ejection fraction following cardiac rehabilitation: impact of endothelial function. Heart Vessels 33(8):886–892

    Article  Google Scholar 

  21. Sexton WL, Korthuis RJ, Laughlin MH (1988) High-intensity exercise training increases vascular transport capacity of rat hindquarters. Am J Physiol 254(2 Pt 2):H274–H278

    CAS  Google Scholar 

  22. Lash JM, Bohlen HG (1992) Functional adaptations of rat skeletal muscle arterioles to aerobic exercise training. J Appl Physiol (1985) 72(6):2052–62

    Article  CAS  Google Scholar 

  23. Katz SD, Yuen J, Bijou R, LeJemtel TH (1997) Training improves endothelium-dependent vasodilation in resistance vessels of patients with heart failure. J Appl Physiol (1985) 82(5):1488–92

    Article  CAS  Google Scholar 

  24. Sinoway LI, Shenberger J, Wilson J, McLaughlin D, Musch T, Zelis R (1987) A 30-day forearm work protocol increases maximal forearm blood flow. J Appl Physiol (1985) 62(3):1063–7

    Article  CAS  Google Scholar 

  25. Wang J, Yi GH, Knecht M, Cai BL, Poposkis S, Packer M et al (1997) Physical training alters the pathogenesis of pacing-induced heart failure through endothelium-mediated mechanisms in awake dogs. Circulation 96(8):2683–2692

    Article  CAS  Google Scholar 

  26. Sarullo FM, Fazio G, Brusca I, Fasullo S, Paterna S, Licata P et al (2010) Cardiopulmonary exercise testing in patients with chronic heart failure: prognostic comparison from peak VO2 and VE/VCO2 slope. Open Cardiovasc Med J 4:127–134

    Article  CAS  Google Scholar 

  27. Arena R, Myers J, Hsu L, Peberdy MA, Pinkstaff S, Bensimhon D et al (2007) The minute ventilation/carbon dioxide production slope is prognostically superior to the oxygen uptake efficiency slope. J Card Fail 13(6):462–469

    Article  Google Scholar 

  28. Coats AJ, Adamopoulos S, Radaelli A, McCance A, Meyer TE, Bernardi L et al (1992) Controlled trial of physical training in chronic heart failure. Exercise performance, hemodynamics, ventilation, and autonomic function. Circulation 85(6):2119–31

    Article  CAS  Google Scholar 

  29. Sturm B, Quittan M, Wiesinger GF, Stanek B, Frey B, Pacher R (1999) Moderate-intensity exercise training with elements of step aerobics in patients with severe chronic heart failure. Arch Phys Med Rehabil 80(7):746–750

    Article  CAS  Google Scholar 

  30. Rengo JL, Savage PD, Barrett T, Ades PA (2018) Cardiac rehabilitation participation rates and outcomes for patients with heart failure. J Cardiopulm Rehabil Prev 38(1):38–42

    Article  Google Scholar 

  31. Reindl I, Kleber FX (1996) Exertional hyperpnea in patients with chronic heart failure is a reversible cause of exercise intolerance. Basic Res Cardiol 91(Suppl 1):37–43

    Article  CAS  Google Scholar 

  32. Adamopoulos S, Parissis J, Karatzas D, Kroupis C, Georgiadis M, Karavolias G et al (2002) Physical training modulates proinflammatory cytokines and the soluble Fas/soluble Fas ligand system in patients with chronic heart failure. J Am Coll Cardiol 39(4):653–663

    Article  CAS  Google Scholar 

  33. Adams V, Linke A, Krankel N, Erbs S, Gielen S, Mobius-Winkler S et al (2005) Impact of regular physical activity on the NAD(P)H oxidase and angiotensin receptor system in patients with coronary artery disease. Circulation 111(5):555–562

    Article  CAS  Google Scholar 

  34. Unger T, Li J (2004) The role of the renin-angiotensin-aldosterone system in heart failure. J Renin Angiotensin Aldosterone Syst 5(Suppl 1):S7-10

    Article  CAS  Google Scholar 

  35. Kawano H, Do YS, Kawano Y, Starnes V, Barr M, Law RE et al (2000) Angiotensin II has multiple profibrotic effects in human cardiac fibroblasts. Circulation 101(10):1130–1137

    Article  CAS  Google Scholar 

  36. Liu JL, Irvine S, Reid IA, Patel KP, Zucker IH (2000) Chronic exercise reduces sympathetic nerve activity in rabbits with pacing-induced heart failure: a role for angiotensin II. Circulation 102(15):1854–1862

    Article  CAS  Google Scholar 

  37. Gao L, Wang W, Li YL, Schultz HD, Liu D, Cornish KG et al (2004) Superoxide mediates sympathoexcitation in heart failure: roles of angiotensin II and NAD(P)H oxidase. Circ Res 95(9):937–944

    Article  CAS  Google Scholar 

  38. Poole-Wilson PA, Buller NP (1988) Causes of symptoms in chronic congestive heart failure and implications for treatment. Am J Cardiol 62(2):31A-A34

    Article  CAS  Google Scholar 

  39. Sullivan MJ, Green HJ, Cobb FR (1991) Altered skeletal muscle metabolic response to exercise in chronic heart failure. Relation to skeletal muscle aerobic enzyme activity. Circulation 84(4):1597–607

    Article  CAS  Google Scholar 

  40. Wilson JR, Martin JL, Schwartz D, Ferraro N (1984) Exercise intolerance in patients with chronic heart failure: role of impaired nutritive flow to skeletal muscle. Circulation 69(6):1079–1087

    Article  CAS  Google Scholar 

  41. Anker SD, Egerer KR, Volk HD, Kox WJ, Poole-Wilson PA, Coats AJ (1997) Elevated soluble CD14 receptors and altered cytokines in chronic heart failure. Am J Cardiol 79(10):1426–1430

    Article  CAS  Google Scholar 

  42. Levine B, Kalman J, Mayer L, Fillit HM, Packer M (1990) Elevated circulating levels of tumor necrosis factor in severe chronic heart failure. N Engl J Med 323(4):236–241

    Article  CAS  Google Scholar 

  43. Swan JW, Anker SD, Walton C, Godsland IF, Clark AL, Leyva F et al (1997) Insulin resistance in chronic heart failure: relation to severity and etiology of heart failure. J Am Coll Cardiol 30(2):527–532

    Article  CAS  Google Scholar 

  44. Dunnigan A, Staley NA, Smith SA, Pierpont ME, Judd D, Benditt DG et al (1987) Cardiac and skeletal muscle abnormalities in cardiomyopathy: comparison of patients with ventricular tachycardia or congestive heart failure. J Am Coll Cardiol 10(3):608–618

    Article  CAS  Google Scholar 

  45. Lipkin DP, Jones DA, Round JM, Poole-Wilson PA (1988) Abnormalities of skeletal muscle in patients with chronic heart failure. Int J Cardiol 18(2):187–195

    Article  CAS  Google Scholar 

  46. Walker PM, Idstrom JP, Schersten T, Bylund-Fellenius AC (1982) Metabolic response in different muscle types to reduced blood flow during exercise in perfused rat hindlimb. Clin Sci (Lond) 63(3):293–299

    Article  CAS  Google Scholar 

  47. Holloszy JO (1976) Adaptations of muscular tissue to training. Prog Cardiovasc Dis 18(6):445–458

    Article  CAS  Google Scholar 

  48. Saltin B, Henriksson J, Nygaard E, Andersen P, Jansson E (1977) Fiber types and metabolic potentials of skeletal muscles in sedentary man and endurance runners. Ann N Y Acad Sci 301:3–29

    Article  CAS  Google Scholar 

  49. Tesch PA, Karlsson J (1985) Muscle fiber types and size in trained and untrained muscles of elite athletes. J Appl Physiol (1985) 59(6):1716–20

    Article  CAS  Google Scholar 

  50. Thorstensson A, Karlsson J (1976) Fatiguability and fibre composition of human skeletal muscle. Acta Physiol Scand 98(3):318–322

    Article  CAS  Google Scholar 

  51. Holloszy JO, Coyle EF (1984) Adaptations of skeletal muscle to endurance exercise and their metabolic consequences. J Appl Physiol Respir Environ Exerc Physiol 56(4):831–838

    CAS  Google Scholar 

  52. Adamopoulos S, Coats AJ, Brunotte F, Arnolda L, Meyer T, Thompson CH et al (1993) Physical training improves skeletal muscle metabolism in patients with chronic heart failure. J Am Coll Cardiol 21(5):1101–1106

    Article  CAS  Google Scholar 

  53. Jessup M, Brozena S (2003) Heart failure. N Engl J Med 348(20):2007–2018

    Article  Google Scholar 

  54. Bjarnason-Wehrens B, Nebel R, Jensen K, Hackbusch M, Grilli M, Gielen S et al (2020) Exercise-based cardiac rehabilitation in patients with reduced left ventricular ejection fraction: the cardiac rehabilitation outcome study in heart failure (CROS-HF): a systematic review and meta-analysis. Eur J Prev Cardiol 27(9):929–952

    Article  Google Scholar 

  55. Piepoli MF, Davos C, Francis DP, Coats AJ, ExTra MC (2004) Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ 328(7433):189

    Article  CAS  Google Scholar 

  56. Sagar VA, Davies EJ, Briscoe S, Coats AJ, Dalal HM, Lough F et al (2015) Exercise-based rehabilitation for heart failure: systematic review and meta-analysis. Open Heart 2(1):e000163

  57. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 6(7):e1000097

  58. Schürmann J et al (2021) Patients with heart failure during and after inpatient cardiac rehabilitation. Vasc Health Risk Manag 17:49

    Article  Google Scholar 

  59. Taylor RS, Walker S, Smart NA, Piepoli MF, Warren FC, Ciani O, ... Collaboration ExTraMATCH II (2018) Impact of exercise-based cardiac rehabilitation in patients with heart failure (ExTraMATCH II) on mortality and hospitalisation: an individual patient data meta-analysis of randomised trials. Eur J Heart Fail 20(12):1735–1743

    Article  Google Scholar 

  60. Sabbag A, Mazin I, Rott D, Hay I, Gang N, Tzur B, ... Israel A (2018) The prognostic significance of improvement in exercise capacity in heart failure patients who participate in cardiac rehabilitation programme. Eur J Prev Cardiol 25(4):354–361

    Article  Google Scholar 

  61. Testa G, Cacciatore F, Bianco A, Della-Morte D, Mazzella F, Galizia G, ... Abete P (2017) Chronic obstructive pulmonary disease and long-term mortality in elderly subjects with chronic heart failure. Aging Clin Exp Res 29(6):1157–1164

    Article  Google Scholar 

  62. Barlow CW, Qayyum MS, Davey PP, Conway J, Paterson DJ, Robbins PA (1994) Effect of physical training on exercise-induced hyperkalemia in chronic heart failure. Relation with ventilation and catecholamines. Circulation 89(3):1144–1152

    CAS  Google Scholar 

  63. Adamopoulos S, Ponikowski P, Cerquetani E, Piepoli M, Rosano G, Sleight P, Coats AJS (1995) Circadian pattern of heart rate variability in chronic heart failure patients Effects of physical training. Eur Heart J 16(10):1380–1386

    Article  CAS  Google Scholar 

  64. Meyer K, Schwaibold M, Westbrook S, Beneke R, Hajric R, Görnandt L, ... Roskamm H (1996) Effects of short-term exercise training and activity restriction on functional capacity in patients with severe chronic congestive heart failure. Am J Cardiol 78(9):1017–1022

    Article  CAS  Google Scholar 

  65. Cahalin LP, Semigran MJ, Dec GW (1997) Inspiratory muscle training in patients with chronic heart failure awaiting cardiac transplantation: results of a pilot clinical trial. Phys Ther 77(8):830–838

    Article  CAS  Google Scholar 

  66. Harrington D, Anker SD, Coats AJS (2001) Preservation of exercise capacity and lack of peripheral changes in asymptomatic patients with severely impaired left ventricular function. Eur Heart J 22(5):392–399

    Article  CAS  Google Scholar 

  67. Corrà U, Mezzani A, Bosimini E, Scapellato F, Imparato A, Giannuzzi P (2002) Ventilatory response to exercise improves risk stratification in patients with chronic heart failure and intermediate functional capacity. Am Heart J 143(3):418–426

    Article  Google Scholar 

  68. Freimark D, Shechter M, Schwamenthal E, Tanne D, Elmaleh E, Shemesh Y, ... Adler Y (2007) Improved exercise tolerance and cardiac function in severe chronic heart failure patients undergoing a supervised exercise program. Int J Cardiol 116(3):309–314

    Article  Google Scholar 

  69. Beckers PJ, Denollet J, Possemiers NM, Wuyts FL, Vrints CJ, Conraads VM (2008) Combined endurance-resistance training vs. endurance training in patients with chronic heart failure: a prospective randomized study. Eur Heart J 29(15):1858–1866

  70. Van Berendoncks AM, Beckers P, Hoymans VY, Possemiers N, Wuyts FL, Vrints CJ, Conraads VM (2010) Exercise training reduces circulating adiponectin levels in patients with chronic heart failure. Clin Sci 118(4):281–289

    Article  Google Scholar 

  71. Nishi I, Noguchi T, Iwanaga Y, Furuichi S, Aihara N, Takaki H, Goto Y (2011) Effects of exercise training in patients with chronic heart failure and advanced left ventricular systolic dysfunction receiving β-blockers. Circ J, 1105171230-1105171230

  72. Myers J, Hadley D, Oswald U, Bruner K, Kottman W, Hsu L, Dubach P (2007) Effects of exercise training on heart rate recovery in patients with chronic heart failure. Am Heart J 153(6):1056–1063

    Article  Google Scholar 

  73. Taylor RS, Walker S, Smart NA, Piepoli MF, Warren FC, Ciani O, ... Collaboration ExTraMATCH II (2019) Impact of exercise rehabilitation on exercise capacity and quality-of-life in heart failure: individual participant meta-analysis. J Am Coll Cardiol 73(12):1430–1443

    Article  Google Scholar 

  74. Neto MG, Duraes AR, Conceição LSR, Saquetto MB, Ellingsen Ø, Carvalho VO (2018) High intensity interval training versus moderate intensity continuous training on exercise capacity and quality of life in patients with heart failure with reduced ejection fraction: A systematic review and meta-analysis. Int J Cardiol 261:134–141

    Article  Google Scholar 

  75. Clerico A, Fontana M, Zyw L, Passino C, Emdin M (2007) Comparison of the diagnostic accuracy of brain natriuretic peptide (BNP) and the N-terminal part of the propeptide of BNP immunoassays in chronic and acute heart failure: a systematic review. Clin Chem 53(5):813–822

    Article  CAS  Google Scholar 

  76. Pozehl B, Duncan K, Hertzog M (2008) The effects of exercise training on fatigue and dyspnea in heart failure. Eur J Cardiovasc Nurs 7(2):127–132

    Article  Google Scholar 

  77. Yeh GY, McCarthy EP, Wayne PM, Stevenson LW, Wood MJ, Forman D, ... Phillips RS (2011) Tai chi exercise in patients with chronic heart failure: a randomized clinical trial. Arch Intern Med 171(8):750–757

    Article  Google Scholar 

  78. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634

    Article  CAS  Google Scholar 

  79. Veroniki A, Jackson D, Viechtbauer W, Bender R, Knapp G, Kuss O et al (2015) Recommendations for quantifying the uncertainty in the summary intervention effect and estimating the between-study heterogeneity variance in random-effects meta-analysis. Cochrane Database Syst Rev 25–7

  80. Higgins J (2011) Analysing data and undertaking meta-analyses. Cochrane handbook for systematic reviews of interventions version 51:6

    Google Scholar 

  81. Austin J, Williams R, Ross L, Moseley L, Hutchison S (2005) Randomised controlled trial of cardiac rehabilitation in elderly patients with heart failure. Eur J Heart Fail 7(3):411–417

    Article  Google Scholar 

  82. Belardinelli R, Georgiou D, Cianci G, Purcaro A (1999) Randomized, controlled trial of long-term moderate exercise training in chronic heart failure: effects on functional capacity, quality of life, and clinical outcome. Circulation 99(9):1173–1182

    Article  CAS  Google Scholar 

  83. Belardinelli R, Georgiou D, Cianci G, Purcaro A (2012) 10-year exercise training in chronic heart failure: a randomized controlled trial. J Am Coll Cardiol 60(16):1521–1528

    Article  Google Scholar 

  84. Cider Å, Schaufelberger M, Sunnerhagen KS, Andersson B (2003) Hydrotherapy—a new approach to improve function in the older patient with chronic heart failure. Eur J Heart Fail 5(4):527–535

    Article  Google Scholar 

  85. Cider A, Tygesson H, Hedberg M, Seligman L, Wennerblom B, Sunnerhagen K (1997) Peripheral muscle training in patients with clinical signs of heart failure. Scand J Rehabil Med 29(2):121–127

    CAS  Google Scholar 

  86. Dalal HM, Taylor RS, Jolly K, Davis RC, Doherty P, Miles J et al (2019) The effects and costs of home-based rehabilitation for heart failure with reduced ejection fraction: the REACH-HF multicentre randomized controlled trial. Eur J Prev Cardiol 26(3):262–272

    Article  Google Scholar 

  87. Davidson PM, Cockburn J, Newton PJ, Webster JK, Betihavas V, Howes L et al (2010) Can a heart failure-specific cardiac rehabilitation program decrease hospitalizations and improve outcomes in high-risk patients? Eur J Prev Cardiol 17(4):393–402

    Article  Google Scholar 

  88. Dracup K, Evangelista LS, Hamilton MA, Erickson V, Hage A, Moriguchi J et al (2007) Effects of a home-based exercise program on clinical outcomes in heart failure. Am Heart J 154(5):877–883

    Article  Google Scholar 

  89. Dubach P, Myers J, Dziekan G, Goebbels U, Reinhart W, Muller P et al (1997) Effect of high intensity exercise training on central hemodynamic responses to exercise in men with reduced left ventricular function. J Am Coll Cardiol 29(7):1591–1598

    Article  CAS  Google Scholar 

  90. Ellingsen Ø, Halle M, Conraads V, Støylen A, Dalen H, Delagardelle C et al (2017) High-intensity interval training in patients with heart failure with reduced ejection fraction. Circulation 135(9):839–849

    Article  Google Scholar 

  91. Giannuzzi P, Temporelli PL, Corrà U, Gattone M, Giordano A, Tavazzi L et al (1997) Attenuation of unfavorable remodeling by exercise training in postinfarction patients with left ventricular dysfunction: results of the exercise in left ventricular dysfunction (ELVD) trial. Circulation 96(6):1790–1797

    Article  CAS  Google Scholar 

  92. Giannuzzi P, Temporelli PL, Corrà U, Tavazzi L (2003) Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure: results of the exercise in left ventricular dysfunction and chronic heart failure (ELVD-CHF) trial. Circulation 108(5):554–559

    Article  Google Scholar 

  93. Gielen S, Adams V, Möbius-Winkler S, Linke A, Erbs S, Yu J et al (2003) Anti-inflammatory effects of exercise training in the skeletal muscle of patients with chronic heart failure. J Am Coll Cardiol 42(5):861–868

    Article  CAS  Google Scholar 

  94. Hambrecht R, Fiehn E, Weigl C, Gielen S, Hamann C, Kaiser R et al (1998) Regular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with chronic heart failure. Circulation 98(24):2709–15

    Article  CAS  Google Scholar 

  95. Hambrecht R, Gielen S, Linke A, Fiehn E, Yu J, Walther C et al (2000) Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure: a randomized trial. JAMA 283(23):3095–3101

    Article  CAS  Google Scholar 

  96. Höllriegel R, Winzer EB, Linke A, Adams V, Mangner N, Sandri M et al (2016) Long-term exercise training in patients with advanced chronic heart failure. J Cardiopulm Rehabil Prev 36(2):117–124

    Article  Google Scholar 

  97. Jolly K, Taylor RS, Lip GY, Davies M, Davis R, Mant J et al (2009) A randomized trial of the addition of home-based exercise to specialist heart failure nurse care: the birmingham rehabilitation uptake maximisation study for patients with congestive heart failure (BRUM-CHF) study. Eur J Heart Fail 11(2):205–213

    Article  Google Scholar 

  98. Keteyian SJ, Brawner CA, Schairer JR, Levine TB, Levine AB, Rogers FJ et al (1999) Effects of exercise training on chronotropic incompetence in patients with heart failure. Am Heart J 138(2):233–240

    Article  CAS  Google Scholar 

  99. Kiilavuori K, Näveri H, Salmi T, Härkönen M (2000) The effect of physical training on skeletal muscle in patients with chronic heart failure. Eur J Heart Fail 2(1):53–63

    Article  CAS  Google Scholar 

  100. Klecha A, Kawecka-Jaszcz K, Bacior B, Kubinyi A, Pasowicz M, Klimeczek P et al (2007) Physical training in patients with chronic heart failure of ischemic origin: effect on exercise capacity and left ventricular remodeling. Eur J Prev Cardiol 14(1):85–91

    Article  Google Scholar 

  101. Mueller L, Myers J, Kottman W, Oswald U, Boesch C, Arbrol N et al (2007) Exercise capacity, physical activity patterns and outcomes six years after cardiac rehabilitation in patients with heart failure. Clin Rehabil 21(10):923–931

    Article  Google Scholar 

  102. Myers J, Goebbels U, Dzeikan G, Froelicher V, Bremerich J, Mueller P et al (2000) Exercise training and myocardial remodeling in patients with reduced ventricular function: one-year follow-up with magnetic resonance imaging. Am Heart J 139(2):252–261

    Article  CAS  Google Scholar 

  103. Myers J, Hadley D, Oswald U, Bruner K, Kottman W, Hsu L et al (2007) Effects of exercise training on heart rate recovery in patients with chronic heart failure. Am Heart J 153(6):1056–1063

    Article  Google Scholar 

  104. Nilsson BB, Westheim A, Risberg MA (2008) Long-term effects of a group-based high-intensity aerobic interval-training program in patients with chronic heart failure. Am J Cardiol 102(9):1220–1224

    Article  Google Scholar 

  105. Norman JF, Pozehl BJ, Duncan KA, Hertzog MA, Krueger SK (2012) Effects of exercise training versus attention on plasma B-type natriuretic peptide, 6-minute walk test and quality of life in individuals with heart failure. Cardiopulm Phys Ther J 23(4):19

    Article  Google Scholar 

  106. O’Connor CM, Whellan DJ, Lee KL, Keteyian SJ, Cooper LS, Ellis SJ et al (2009) Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA 301(14):1439–1450

    Article  Google Scholar 

  107. Passino C, Severino S, Poletti R, Piepoli MF, Mammini C, Clerico A et al (2006) Aerobic training decreases B-type natriuretic peptide expression and adrenergic activation in patients with heart failure. J Am Coll Cardiol 47(9):1835–1839

    Article  CAS  Google Scholar 

  108. Pozehl B, Duncan K, Hertzog M (2008) The effects of exercise training on fatigue and dyspnea in heart failure. Eur J Cardiovasc Nurs 7(2):127–132

    Article  Google Scholar 

  109. Sabelis L, Senden P, Fijnheer R, De Groot P, Huisveld I, Mosterd W et al (2004) Endothelial markers in chronic heart failure: training normalizes exercise-induced vWF release. Eur J Clin Invest 34(9):583–589

    Article  CAS  Google Scholar 

  110. Tyni-Lenné R, Gordon A, Sylvén C (1996) Improved quality of life inchronic heart failure patients following local endurance training with leg muscles. J Cardiac Fail 2(2):111–117

    Article  Google Scholar 

  111. Wielenga R, Huisveld I, Bol E, Dunselman P, Erdman R, Baselier M et al (1999) Safety and effects of physical training in chronic heart failure. Results of the chronic heart failure and graded exercise study (CHANGE) (CHANGE). Eur Heart J 20(12):872–9

    Article  CAS  Google Scholar 

  112. Willenheimer R, Erhardt L, Cline C, Rydberg E, Israelsson B (1998) Exercise training in heart failure improves quality of life and exercise capacity. Eur Heart J 19(5):774–781

    Article  CAS  Google Scholar 

  113. Witham MD, Fulton RL, Greig CA, Johnston DW, Lang CC, van der Pol M et al (2012) Efficacy and cost of an exercise program for functionally impaired older patients with heart failure: a randomized controlled trial. Circ Heart Fail 5(2):209–16

    Article  Google Scholar 

  114. Yeh GY, McCarthy EP, Wayne PM, Stevenson LW, Wood MJ, Forman D et al (2011) Tai chi exercise in patients with chronic heart failure: a randomized clinical trial. Arch Intern Med 171(8):750–757

    Article  Google Scholar 

  115. McKelvie RS, Teo KK, Roberts R, McCartney N, Humen D, Montague T et al (2002) Effects of exercise training in patients with heart failure: the exercise rehabilitation trial (EXERT). Am Heart J 144(1):23–30

    Article  Google Scholar 

  116. Oldridge N (2012) Exercise-based cardiac rehabilitation in patients with coronary heart disease: meta-analysis outcomes revisited. Future Cardiol 8(5):729–751

    Article  CAS  Google Scholar 

  117. Croft JB, Giles WH, Pollard RA, Keenan NL, Casper ML, Anda RF (1999) Heart failure survival among older adults in the United States: a poor prognosis for an emerging epidemic in the medicare population. Arch Intern Med 159(5):505–510

    Article  CAS  Google Scholar 

  118. Dracup K, Walden JA, Stevenson LW, Brecht ML (1992) Quality of life in patients with advanced heart failure. J Heart Lung Transplant 11(2 Pt 1):273–279

    CAS  Google Scholar 

  119. Konstam V, Salem D, Pouleur H, Kostis J, Gorkin L, Shumaker S et al (1996) Baseline quality of life as a predictor of mortality and hospitalization in 5,025 patients with congestive heart failure. SOLVD investigations. Studies of left ventricular dysfunction investigators. Am J Cardiol 78(8):890–5

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Students’ Scientific Research Center (SSRC), Tehran University of Medical Science, Tehran, Iran

    Negin Sadat Hosseini Mohammadi, Mohammad Hasan Shaki Katouli & Kiarash Tavakoli

  2. Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Heyaat Avenue, Kargar St. Jalal Al-Ahmad, Tehran, 1411713138, Iran

    Negin Sadat Hosseini Mohammadi, Mohammad Hasan Shaki Katouli, Farzad Masoudkabir, Alipasha Meysamie, Kiarash Tavakoli & Ali Vasheghani-Farahani

  3. Department of Cardiac Electrophysiology, Tehran Heart Center, Tehran University of Medical Science, Kargar St. Jalal Al-Ahmad , Tehran, 1411713138, Iran

    Farzad Masoudkabir & Ali Vasheghani-Farahani

  4. Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Science, Tehran, Iran

    Alipasha Meysamie

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  1. Negin Sadat Hosseini Mohammadi
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Correspondence to Farzad Masoudkabir.

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Hosseini Mohammadi, N.S., Shaki Katouli, M.H., Masoudkabir, F. et al. Cardiac rehabilitation in heart failure with severely reduced ejection fraction: effects on mortality. Heart Fail Rev 28, 1–19 (2023). https://doi.org/10.1007/s10741-022-10242-w

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