Presentation Type: Speech
Cardiac rehabilitation (CR)/secondary prevention programs are recognized as comprehensive care of patients with chronic heart failure (CHF). Effective CR for CHF includes both supervised exercise training and self -care planning. Programs that consist of exercise training alone are not considered CR. Exercise training and CHF disease-related self-care counseling are both recommended by the American Heart Association (AHA) and the American College of Cardiology (ACC) as useful and effective in CHF at the Class I level. CR, which combines exercise training and self-care, is recommended by the ACC at the Class IIa level. The prevalence and incidence of CHF are increasing, largely due to the aging of the population. CHF is the leading cause of hospitalization in the Medicare age group, accounting for >1 million admissions annually, and it is also a major source of diminished functional capacity, impaired quality of life, disability, and mortality. Despite major advances in CHF therapies, most patients continue to experience exercise intolerance due to intrinsic abnormalities of cardiac function coupled with maladaptive changes in skeletal muscles, the vasculature, and pulmonary circulation. Additionally, the magnitude of the exercise intolerance, as measured by peak oxygen uptake (VO2), is strongly and independently associated with prognosis in patients with CHF. Although CHF was once considered a contraindication to exercise, numerous studies demonstrate that regular exercise is safe and associated with a multitude of benefits in appropriately selected patients. This part of pannel will delineate the role of structured CR, including exercise training and self-care counseling, in patients with CHF and makes recommendations for the selection of appropriate patients for coverage of a CR benefit.