The role of cardiac rehabilitation in heart failure patients

Several observations have progressively led to cardiac rehabilitation (CR) being considered an important part of cardiovascular prevention. This in turn has led to various intervention programmes being developed to identify and modify risk factors and consequently reduce morbidity and mortality in patients with established heart diseases. Therefore, as a result of this, CR programmes have been developed for patients after myocardial infarction, coronary artery bypass graft surgery and percutaneous intervention. However, limited information is available on the usefulness of rehabilitation programmes in the clinical management of patients with chronic heart failure, and studies have been developed recently to evaluate the outcome of supervised physical training on patients with chronic heart failure. In this article we review the most recent studies on CR in patients with heart failure. We also highlight the need for additional studies in order to evaluate the risk of exercise for patients with diagnosed or occult cardiovascular disease and, especially, to evaluate the role of physical activity relative to other interventions, and also the impact on healthcare costs.