Early Cardiac Rehabilitation Benefits Non-Frail Patients With ADHF

Patients with acute decompensated heart failure (ADHF) who are not considered physically frail appeared to benefit from in-hospital, exercise-based cardiac rehabilitation, according to the results of a study published in JACC: Heart Failure.

In the ACTIVE-ADHF trial, researchers enrolled 91 patients with ADHF and randomly assigned them 2:1 to either exercise-based cardiac rehabilitation or standard care. Patients assigned to the intervention had early mobilization and structured exercise training. All included patients had preserved physical function defined as a Short Physical Performance Battery score greater than or equal to 10 points.

There was a significantly greater improvement in the primary outcome of change in six-minute walk distance (6MWD) from baseline to discharge among patients assigned to cardiac rehabilitation compared with those assigned to standard care. The mean increase in the 6MWD was 75 minutes compared with 44 minutes in the control group. Eighty percent of patients assigned the intervention had a clinically significant improvement in the 6MWD compared with 60% in the control group (odds ratio=6.01; 95% CI, 1.67-21.6; P=.006).

Assignment to cardiac rehabilitation also resulted in improvements in several secondary outcomes including chair rise time, gait speed, and cognitive function. The intervention group continued to show positive outcomes in instrumental activities of daily living one month after hospital discharge.

“These findings are particularly important for middle-aged and older ADHF patients aiming to resume daily activities such as shopping, housework, or employment,” the researchers noted.

Despite some of the study’s limitations, such as the small number of patients included, “this study provides valuable insights into the potential efficacy and safety of early inpatient CR for patients with ADHF who are not frail.”