Does exercise-based cardiac rehabilitation improve hemodynamic parameters in heart failure? A controlled trial
DOI:
https://doi.org/10.61882/MEJNCD.1.1.4Keywords:
Heart Failure, Hemodynamic Monitoring, Cardiovascular RehabilitationsAbstract
Background: Heart failure (HF), particularly heart failure with reduced ejection fraction(HFrEF), presents significant challenges owing to its progressive nature and hemodynamic implications. Cardiac rehabilitation (CR) offers a comprehensive approach to HF management,including exercise training, which holds promise in enhancing cardiac function. Nonetheless,there is a need to explore the specific impact of concurrent exercise training on hemodynamic parameters in HFrEF patients.
Method: This randomized, two-arm parallel clinical trial adhered to CONSORT guidelines and enrolled patients with documented HFrEF. Participants were allocated into concurrent exercise
training and control groups, with hemodynamic parameters assessed at baseline and after eight weeks. The concurrent exercise training consisted of an eight-week program involving three aerobic and two resistance exercise sessions per week, along with daily breathing exercises.Measurements included systolic and diastolic pressures, heart rate, and rate-pressure product (RPP). Statistical analysis utilized two-way repeated-measures ANOVA to evaluate changes over time and between groups.
Results: Of the 80 initially assessed patients, 76 completed the eight-week intervention without adverse events. While the intervention group showed a trend toward decreased RPP compared to baseline (p = 0.126), a significant interaction between time and group (p = 0.003) indicated the intervention's effect on RPP over time. Systolic blood pressure remained stable in both
groups, whereas diastolic blood pressure exhibited minimal changes. The intervention group experienced a significant decrease in heart rate (p = 0.003) along with a significant interaction between time and group (p = 0.011), indicating the impact of exercise-based cardiac rehabilitation on heart rate.
Conclusion: Despite non-significant changes, reduced heart rate and altered RPP suggest the efficacy of exercise-based cardiac rehabilitation. Future research should explore mechanisms and long-term outcomes, emphasizing the importance of concurrent exercise training for improving patient outcomes and quality of life in managing HF .
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