Heart Failure as a Newly Approved Diagnosis for Cardiac Rehabilitation

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:65

Article

Forman, Daniel E.^1,2,3  Sanderson, Bonnie K.^4,5  Josephson, Richard A.⁶  Raikhelkar, Jayant⁷  Bittner, Vera⁸ 

[1] Univ Pittsburgh, Med Ctr, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA

[2] Univ Pittsburgh, Med Ctr, Div Cardiol, Pittsburgh, PA USA

[3] Univ Pittsburgh, Vet Adm Pittsburgh Healthcare Syst, Pittsburgh, PA USA

[4] Auburn Univ, Sch Nursing, Dept Med, Div Cardiol, Auburn, AL 36849 USA

[5] Auburn Univ, Sch Nursing, Dept Med, Div Geriatr Med, Auburn, AL 36849 USA

[6] Case Western Reserve Univ, Univ Hosp Hlth Syst, Sch Med, Harrington Heart & Vasc Inst,Dept Med, Cleveland, OH 44106 USA

[7] Case Western Reserve Univ, Univ Hosp Hlth Syst, Sch Med, Cleveland, OH 44106 USA

[8] Univ Alabama Birmingham, Dept Med, Div Cardiovasc Dis, Birmingham, AL 35294 USA

关键词: adherence;    exercise training;    randomized controlled trial;   

DOI  :  10.1016/j.jacc.2015.04.052

来源: Elsevier

【 摘 要 】

Many see the broadened eligibility of cardiac rehabilitation (CR) to include heart failure with reduced ejection fraction (HFrEF) as a likely catalyst to high CR enrollment and improved care. However, such expectation contrasts with the reality that CR enrollment of eligible coronary heart disease patients has remained low for decades. In this review, entrenched obstacles impeding utilization of CR are considered, particularly in relation to potential HFrEF management. The strengths and limitations of the HF-ACTION (Heart Failure-A Controlled Trial Investigating Outcomes of Exercise Training) trial to advance precepts of CR are considered, as well as gaps that this trial failed to address, such as the utility of CR for patients with heart failure with preserved ejection fraction and the conundrum of poor patient adherence. (C) 2015 by the American College of Cardiology Foundation.

【 授权许可】

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