BACKGROUND: Although cardiac rehabilitation (CR) can improve exercise capacity and quality of life in patients with chronic heart failure (HF), the long-term prognostic influence of inpatient CR on patients with acute decompensated HF (ADHF) is not well established. We examined the impact of inpatient CR on disability and prognosis in patients with ADHF. METHODS: A total of 171 patients admitted for ADHF underwent CR that included resistance training and aerobic exercise. Patient disability was evaluated using Barthel Index (BI) scores at pre- (BIpre) and post- (BIpost) rehabilitation. All-cause mortality was retrospectively recorded after discharge. RESULTS: In the study cohort (median age: 76 years), 46 patients experienced all-cause mortality during a median of 478 days of follow-up. Impaired BIpost (i.e., BI < 60) was significantly correlated with older age and lower albumin, hemoglobin, estimated glomerular filtration rate (eGFR), and B-type natriuretic peptide (BNP). In Kaplan-Meier analysis, impaired BIpre and BIpost were significantly associated with all-cause mortality. Better outcomes were observed for improved BI (ΔBI > 15) among patients with impaired baseline BI. BIpost was an independent predictor of all-cause mortality after adjusting for age, sex, eGFR, BNP, hemoglobin, albumin, and left ventricular ejection fraction. CONCLUSIONS: Inpatient CR led to improvements in disabilities among patients with ADHF. Baseline disabilities were associated with a poor prognosis. Greater improvements in BI to inpatient CR were significantly related to better outcomes in patients with impaired baseline BI. CR should be indicated for patients with ADHF.
BACKGROUND: Although cardiac rehabilitation (CR) can improve exercise capacity and quality of life in patients with chronic heart failure (HF), the long-term prognostic influence of inpatient CR on patients with acute decompensated HF (ADHF) is not well established. We examined the impact of inpatient CR on disability and prognosis in patients with ADHF. METHODS: A total of 171 patients admitted for ADHF underwent CR that included resistance training and aerobic exercise. Patient disability was evaluated using Barthel Index (BI) scores at pre- (BIpre) and post- (BIpost) rehabilitation. All-cause mortality was retrospectively recorded after discharge. RESULTS: In the study cohort (median age: 76 years), 46 patients experienced all-cause mortality during a median of 478 days of follow-up. Impaired BIpost (i.e., BI < 60) was significantly correlated with older age and lower albumin, hemoglobin, estimated glomerular filtration rate (eGFR), and B-type natriuretic peptide (BNP). In Kaplan-Meier analysis, impaired BIpre and BIpost were significantly associated with all-cause mortality. Better outcomes were observed for improved BI (ΔBI > 15) among patients with impaired baseline BI. BIpost was an independent predictor of all-cause mortality after adjusting for age, sex, eGFR, BNP, hemoglobin, albumin, and left ventricular ejection fraction. CONCLUSIONS: Inpatient CR led to improvements in disabilities among patients with ADHF. Baseline disabilities were associated with a poor prognosis. Greater improvements in BI to inpatient CR were significantly related to better outcomes in patients with impaired baseline BI. CR should be indicated for patients with ADHF.