Benefits of cardiac rehabilitation in heart failure patients according to etiology: INCARD French study

François Koukoui, Franck Desmoulin, Gérard Lairy, Dominique Bleinc, Ludovic Boursiquot, Michel Galinier, Fatima Smih, Philippe Rouet, François Koukoui, Franck Desmoulin, Gérard Lairy, Dominique Bleinc, Ludovic Boursiquot, Michel Galinier, Fatima Smih, Philippe Rouet

Abstract

We investigated the impact of heart failure (HF) etiology on the outcome of cardiac rehabilitation (CR) assessed by functional and clinical parameters. Treatment of chronic HF requires multidisciplinary approaches with a recognized role for CR. INCARD is a French study aimed at evaluating the benefits of sustainable CR in coronary (C) and noncoronary patients (NC) treated and educated during a 24-month period of follow-up. Prospective, monocentric patients with HF underwent inpatient physical training followed by a home-based program. Evaluations were performed at inclusion, discharge, 3 months after discharge, and subsequently every 6 months over the 24 months of outpatient rehabilitation.A total of 147 HF patients with left ventricular ejection fraction (LVEF) <40 were admitted to the CR center, 63 accepted to join INCARD (29 C and 34 NC). Although the C participants C having both an echocardiographic LVEF and an initially lower peak VO2, inpatient rehabilitation improved all functional parameters. Only NC showed an improved LVEF during the first 3 months of outpatient-follow-up. The main outcome of the outpatient rehabilitation was a trend toward stabilization of clinical and laboratory parameters with no significant difference between C and NC. This study confirms the benefits of initial HF inpatient rehabilitation and encourages prolonged outpatient monitoring. The results on functional parameters suggest exercise training should be conducted regardless of the HF etiology.

Trial registration: ClinicalTrials.gov NCT01683903.

Conflict of interest statement

The authors have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow-chart of the study. C = coronary patients, HF = heart failure, LVEF = left ventricular ejection fraction, NC = noncoronary patients.
FIGURE 2
FIGURE 2
Medication management during the follow-up. Percentages of coronary (A) and noncoronary (B) patients treated with beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), loop diuretics, anti-aldosterone, or angiotensin II receptor blockers (ARBs) are indicated for each evaluation during the inpatient follow-up (I) period and outpatient follow-up (O) period. ∗% treated patients significantly different between C and NC, P < 0.05.

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Source: PubMed

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