Highlights from

ACC 2021

American College of Cardiology Annual Congress 2021

Virtual 15-17 May 2021

Older adults with heart failure benefit from rehabilitation programme

Summary: In the REHAB-HF trial, older patients who experienced acute decompensated heart failure (ADHF) and participated in a physical rehabilitation programme achieved improvements in physical function, Kansas City Cardiomyopathy Questionnaire, and depression scores.1

Older patients with ADHF are often physically frail, have a poor quality of life, and are frequently rehospitalised. Current guidelines fail to address physical functioning in older patients with ADHF. Accordingly, the REHAB-HF trial (NCT02196038) aimed to investigate the effects of a tailored, progressive rehabilitation programme in older adults who had been hospitalised for ADHF. Dr Dalane Kitzman (Wake Forest School of Medicine, North Carolina, US) presented the results. The trial randomised 349 patients to either participate in the rehabilitation programme (n=175) or to receive usual care (n=174). The rehabilitation programme consisted of 36 sessions delivered over 12 weeks and encompassed endurance, mobility, strength, and balance training. The primary outcome was a change in short physical performance battery (SPPB) score, which was assessed at baseline and upon programme completion. The SPPB tests standing balance, walking, and strength. At 3 months, the least-squares mean score on the SPPB score was 8.3±0.2 in the rehabilitation group and 6.9±0.2 in the usual care group. This yielded a mean between-group difference of 1.5 (95%CI 0.9–2.0; P<0.001), deemed to be clinically meaningful. The secondary outcome was all-cause rehospitalisation within 6 months. The rehospitalisation rate at 6 months was 1.18 in the rehabilitation group and 1.28 in the usual care group (rate ratio 0.93; 95% CI 0.66–1.19), results deemed not clinically significant. New England Journal of Medicine editors declare that, “The results presented by Kitzman and colleagues provide a compelling argument for the adoption of exercise rehabilitation as standard care, even for elderly, frail patients with acute heart failure.”2

  1. Kitzman DW. A novel physical rehabilitation intervention for older patients with acute decompensated heart failure: the REHAB-HF trial. ACC Scientific Session, 15-17 May 2021
  2. Anker S D and Coats A J. Exercise for frail, elderly patients with acute heart failure - a strong step forward. N Eng J Med Editorial 2021; 16 May 2021 [full text]

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