Comparative Analysis of cardiac rehabilitation programs versus Standard Care in heart failure with reduced ejection fraction
DOI:
https://doi.org/10.5281/zenodo.22814660Keywords:
cardiac rehabilitation, heart failure, reduced ejection fraction, exercise training, standard careAbstract
Background: Exercise-based cardiac rehabilitation is a class I guideline recommendation for heart failure with reduced ejection fraction (HFrEF), yet its comparative benefit over standard care remains underappreciated in routine practice.
Objective: This review synthesizes randomized trials, meta-analyses, and registry data comparing structured cardiac rehabilitation with standard care alone in HFrEF, focusing on exercise capacity, quality of life, hospitalization, and mortality.
Methods: We reviewed landmark exercise trials, the HF-ACTION trial and substudies, systematic reviews, home-based and telerehabilitation comparisons, and registry analyses of rehabilitation participation and dose-response in HFrEF.
Findings: Cardiac rehabilitation improves peak oxygen uptake and quality of life relative to standard care, and pooled trial data show reduced heart-failure-specific hospitalization with a more modest mortality effect; benefit is concentrated among patients completing a threshold volume of supervised sessions.
Conclusions: Structured rehabilitation, in supervised, home-based, or hybrid formats, produces meaningful gains over standard care alone in HFrEF; closing referral and enrollment gaps is the largest remaining opportunity to translate trial efficacy into population-level benefit.
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