The importance of cardiorehabilitation in the era of modern treatment of cardiovascular diseases
https://doi.org/10.18087/cardio.2022.4.n2015
Abstract
Cardiac rehabilitation (CR) has a class IA indication in international and national guidelines as an intervention with proven efficacy for decreasing cardiovascular and all-cause mortality in various categories of cardiological patients. However, CR is one of the least used current technologies for the treatment of patients with cardiovascular diseases worldwide. This article presents the state of the CR problem during the epoch of high-tech treatments of cardiovascular diseases; the prevalence of using CR in various countries; traditional and new methodological approaches, including telemedicine; and clinical and prognostic effects of CR in various categories of patients with cardiovascular diseases.
Keywords
Cardiac rehabilitation,
physical training,
psychological support,
mortality values,
prognosis,
quality of life
Supporting agencies: No conflict of interest is reported.
About the Author
N. V. Pogosova
National Medical Research Center of Cardiology
Russian Federation
Russian Federation
Deputy General Director for Scientific and Analytical Work and Preventive Cardiology, Professor, MD,PhD
Moscow
References
1. Kotseva K, Wood D, De Bacquer D. Determinants of participation and risk factor control according to attendance in cardiac rehabilitation programmes in coronary patients in Europe: EUROASPIRE IV survey. European Journal of Preventive Cardiology. 2018;25(12):1242–51. DOI: 10.1177/2047487318781359
2. Jernberg T, Hasvold P, Henriksson M, Hjelm H, Thuresson M, Janzon M. Cardiovascular risk in post-myocardial infarction patients: nationwide real world data demonstrate the importance of a long-term perspective. European Heart Journal. 2015;36(19):1163–70. DOI: 10.1093/eurheartj/ehu505
3. Pogosova N.V., Oganov R.G., Boytsov S.A., Ausheva A.K., Sokolova O.Yu., Kursakov A.A. et al. Secondary prevention in patients with coronary artery disease in Russia and Europe: results from the Russian part of the EUROASPIRE V survey. Cardiovascular Therapy and Prevention. 2020;19(6):67–78. DOI: 10.15829/1728-8800-2020-2739
4. Anderson L, Oldridge N, Thompson DR, Zwisler A-D, Rees K, Martin N et al. Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease. Journal of the American College of Cardiology. 2016;67(1):1–12. DOI: 10.1016/j.jacc.2015.10.044
5. Martin B-J, Hauer T, Arena R, Austford LD, Galbraith PD, Lewin AM et al. Cardiac rehabilitation attendance and outcomes in coronary artery disease patients. Circulation. 2012;126(6):677–87. DOI: 10.1161/CIRCULATIONAHA.111.066738
6. Janssen V, Gucht VD, Dusseldorp E, Maes S. Lifestyle modification programmes for patients with coronary heart disease: a systematic review and meta-analysis of randomized controlled trials. European Journal of Preventive Cardiology. 2013;20(4):620–40. DOI: 10.1177/2047487312462824
7. Aronov D.M., Krasnitsky V.В., Bubnova M.G., Pozdnyakov Yu.M., Ioselianl D.V., Schegolkov A.N. et al. Exercise in outpatient complex rehabilitation and secondary prophylaxis in patients with ischemic heart disease after acute coronary events (a cooperative trial in Russia). Therapeutic Archive. 2006;78(9):33–8.
8. Goel K, Lennon RJ, Tilbury RT, Squires RW, Thomas RJ. Impact of cardiac rehabilitation on mortality and cardiovascular events after percutaneous coronary intervention in the community. Circulation. 2011;123(21):2344–52. DOI: 10.1161/CIRCULATIONAHA.110.983536
9. Goel K, Pack QR, Lahr B, Greason KL, Lopez-Jimenez F, Squires RW et al. Cardiac rehabilitation is associated with reduced long-term mortality in patients undergoing combined heart valve and CABG surgery. European Journal of Preventive Cardiology. 2015;22(2):159–68. DOI: 10.1177/2047487313512219
10. McMahon SR, Ades PA, Thompson PD. The role of cardiac rehabilitation in patients with heart disease. Trends in Cardiovascular Medicine. 2017;27(6):420–5. DOI: 10.1016/j.tcm.2017.02.005
11. Sadeghi M, Shabib G, Masoumi G, Amerizadeh A, Shahabi J, Heidari R et al. A Systematic Review and Meta-analysis on the Prevalence of Smoking Cessation in Cardiovascular Patients After Participating in Cardiac Rehabilitation. Current Problems in Cardiology. 2021;46(3):100719. DOI: 10.1016/j.cpcardiol.2020.100719
12. Lawler PR, Filion KB, Eisenberg MJ. Efficacy of exercise-based cardiac rehabilitation post–myocardial infarction: A systematic review and meta-analysis of randomized controlled trials. American Heart Journal. 2011;162(4):571–584.e2. DOI: 10.1016/j.ahj.2011.07.017
13. Suaya JA, Stason WB, Ades PA, Normand S-LT, Shepard DS. Cardiac rehabilitation and survival in older coronary patients. Journal of the American College of Cardiology. 2009;54(1):25–33. DOI: 10.1016/j.jacc.2009.01.078
14. Rauch B, Riemer T, Schwaab B, Schneider S, Diller F, Gohlke H et al. Short-term comprehensive cardiac rehabilitation after AMI is associated with reduced 1-year mortality: results from the OMEGA study. European Journal of Preventive Cardiology. 2014;21(9):1060–9. DOI: 10.1177/2047487313486040
15. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). European Heart Journal. 2016;37(29):2315–81. DOI: 10.1093/eurheartj/ehw106
16. Boytsov S.A., Pogosova N.V., Bubnova M.G., Drapkina O.M., Gavrilova N.E., Yeganyan R.A. et al. Cardiovascular prevention 2017. National guidelines. Russian Journal of Cardiology. 2018;23(6):7–122. DOI: 10.15829/1560-4071-2018-6-7-122
17. Thomas RJ, Balady G, Banka G, Beckie TM, Chiu J, Gokak S et al. 2018 ACC/AHA Clinical Performance and Quality Measures for Cardiac Rehabilitation: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Circulation: Cardiovascular Quality and Outcomes. 2018;11(4):e000037. DOI: 10.1161/HCQ.0000000000000037
18. West RR, Jones DA, Henderson AH. Rehabilitation after myocardial infarction trial (RAMIT): multi-centre randomised controlled trial of comprehensive cardiac rehabilitation in patients following acute myocardial infarction. Heart. 2012;98(8):637–44. DOI: 10.1136/heartjnl-2011-300302
19. Rauch B, Davos CH, Doherty P, Saure D, Metzendorf M-I, Salzwedel A et al. The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy: A systematic review and meta-analysis of randomized and non-randomized studies – The Cardiac Rehabilitation Outcome Study (CROS). European Journal of Preventive Cardiology. 2016;23(18):1914–39. DOI: 10.1177/2047487316671181
20. Salzwedel A, Jensen K, Rauch B, Doherty P, Metzendorf M-I, Hackbusch M et al. Effectiveness of comprehensive cardiac rehabilitation in coronary artery disease patients treated according to contemporary evidence based medicine: Update of the Cardiac Rehabilitation Outcome Study (CROS-II). European Journal of Preventive Cardiology. 2020;27(16):1756–74. DOI: 10.1177/2047487320905719
21. Buckley BJR, de Koning IA, Harrison SL, Fazio-Eynullayeva E, Underhill P, Kemps HMC et al. Exercise-based cardiac rehabilitation vs. percutaneous coronary intervention for chronic coronary syndrome: impact on morbidity and mortality. European Journal of Preventive Cardiology. 2021;zwab191. [Epub ahead of print]. DOI: 10.1093/eurjpc/zwab191
22. Michelsen HÖ, Sjölin I, Schlyter M, Hagström E, Kiessling A, Henriksson P et al. Cardiac rehabilitation after acute myocardial infarction in Sweden – evaluation of programme characteristics and adherence to European guidelines: The Perfect Cardiac Rehabilitation (Perfect-CR) study. European Journal of Preventive Cardiology. 2020;27(1):18–27. DOI: 10.1177/2047487319865729
23. Aronov D.M., Bubnova M.G., Pogosova G.V., Novikova N.K., Krasnitsky V.В., Pozdnyakov Yu.M. et al. Rehabilitation of patients with ischemic heart disease at outpatient stage. Kardiologiia. 2006;46(2):86–99.
24. Bjarnason-Wehrens B, McGee H, Zwisler A-D, Piepoli MF, Benzer W, Schmid J-P et al. Cardiac rehabilitation in Europe: results from the European Cardiac Rehabilitation Inventory Survey. European Journal of Cardiovascular Prevention and Rehabilitation. 2010;17(4):410–8. DOI: 10.1097/HJR.0b013e328334f42d
25. Abreu A, Pesah E, Supervia M, Turk-Adawi K, Bjarnason-Wehrens B, Lopez-Jimenez F et al. Cardiac rehabilitation availability and delivery in Europe: How does it differ by region and compare with other high-income countries?: Endorsed by the European Association of Preventive Cardiology. European Journal of Preventive Cardiology. 2019;26(11):1131–46. DOI: 10.1177/2047487319827453
26. Pesah E, Turk-Adawi K, Supervia M, Lopez-Jimenez F, Britto R, Ding R et al. Cardiac rehabilitation delivery in low/middle-income countries. Heart. 2019;105(23):1806–12. DOI: 10.1136/heartjnl-2018-314486
27. Zwisler A-D, Bjarnason-Wehrens B, McGee H, Piepoli MF, Benzer W, Schmid J-P et al. Can level of education, accreditation and use of databases in cardiac rehabilitation be improved? Results from the European Cardiac Rehabilitation Inventory Survey. European Journal of Preventive Cardiology. 2012;19(2):143–50. DOI: 10.1177/1741826711398847
28. La Rovere MT, Traversi E. Role and efficacy of cardiac rehabilitation in patients with heart failure. Monaldi Archives for Chest Disease. 2019;89(1). DOI: 10.4081/monaldi.2019.1027
29. Iliou MC, Blanchard JC, Lamar-Tanguy A, Cristofini P, Ledru F. Cardiac rehabilitation in patients with pacemakers and implantable cardioverter defibrillators. Monaldi Archives for Chest Disease. 2016;86(1–2):756. DOI: 10.4081/monaldi.2016.756
30. Chong MS, Sit JWH, Karthikesu K, Chair SY. Effectiveness of technology-assisted cardiac rehabilitation: A systematic review and metaanalysis. International Journal of Nursing Studies. 2021;124:104087. DOI: 10.1016/j.ijnurstu.2021.104087
31. Mahfood Haddad T, Saurav A, Smer A, Azzouz MS, Akinapelli A, Williams MA et al. Cardiac Rehabilitation in Patients With Left Ventricular Assist Device: a systematic review and meta-analysis. Journal of Cardiopulmonary Rehabilitation and Prevention. 2017;37(6):390–6. DOI: 10.1097/HCR.0000000000000254
32. Robaye B, Lakiss N, Dumont F, Laruelle C. Atrial fibrillation and cardiac rehabilitation: an overview. Acta Cardiologica. 2020;75(2):116–20. DOI: 10.1080/00015385.2019.1565663
33. Sukul D, Seth M, Barnes GD, Dupree JM, Syrjamaki JD, Dixon SR et al. Cardiac Rehabilitation Use After Percutaneous Coronary Intervention. Journal of the American College of Cardiology. 2019;73(24):3148–52. DOI: 10.1016/j.jacc.2019.03.515
34. Pogosova N, Saner H, Pedersen SS, Cupples ME, McGee H, Höfer S et al. Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology. European Journal of Preventive Cardiology. 2015;22(10):1290–306. DOI: 10.1177/2047487314543075
35. Forman DE. Cardiac Rehabilitation for Older Adults: Vital Opportunity to Improve Patient-Centered Cardiovascular Disease Care amid Worldwide Patient Aging. Clinics in Geriatric Medicine. 2019;35(4):xiii–xiv. DOI: 10.1016/j.cger.2019.08.001
36. Mendes M. The elderly are priority candidates for cardiac rehabilitation. Revista Portuguesa de Cardiologia (Engl Ed). 2021;40(1):21–3. DOI: 10.1016/j.repc.2020.11.002
37. Bravo-Escobar R, González-Represas A, Gómez-González AM, Montiel-Trujillo A, Aguilar-Jimenez R, Carrasco-Ruíz R et al. Effectiveness and safety of a home-based cardiac rehabilitation programme of mixed surveillance in patients with ischemic heart disease at moderate cardiovascular risk: A randomised, controlled clinical trial. BMC Cardiovascular Disorders. 2017;17(1):66. DOI: 10.1186/s12872-017-0499-0
38. Thomas RJ, Beatty AL, Beckie TM, Brewer LC, Brown TM, Forman DE et al. Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation. 2019;140(1):e69–89. DOI: 10.1161/CIR.0000000000000663
39. Kraal JJ, Van den Akker-Van Marle ME, Abu-Hanna A, Stut W, Peek N, Kemps HM. Clinical and cost-effectiveness of home-based cardiac rehabilitation compared to conventional, centre-based cardiac rehabilitation: Results of the FIT@Home study. European Journal of Preventive Cardiology. 2017;24(12):1260–73. DOI: 10.1177/2047487317710803
40. Pogosova N.V., Salbieva A.O., Sokolova O.Yu., Ausheva A.K., Karpova A.V., Eganyan R.A. et al. The Efficacy of Secondary Prevention Programs with Remote Support in Ischemic Heart Disease Patients with Abdominal Obesity. Kardiologiia. 2019;59(11):21–30. DOI: 10.18087/cardio.2019.11.n739
41. Pogosova N.V., Badtieva V.A., Ovchinnikova A.I., Sokolova O.Yu., Vorobyeva N.M. Efficacy of secondary prevention and rehabilitation programs with distant support in patients with atrial fibrillation after intervention procedures: impact on psychological status. Kardiologiia in print. DOI: 10.18087/cardio.2022.3.n1951
42. Nabutovsky I, Nachshon A, Klempfner R, Shapiro Y, Tesler R. Digital Cardiac Rehabilitation Programs: The Future of Patient-Centered Medicine. Telemedicine and e-Health. 2020;26(1):34–41. DOI: 10.1089/tmj.2018.0302
43. Gertsik Yu.G., Ivanova G.E., Omelchenko I.N., Gertsik G.Ya. Innovative aspects of the use of IT technologies in medical devices for rehabilitation. Physical and rehabilitation medicine, medical rehabilitation. 2019;2(2):43–6.
44. Ades PA, Keteyian SJ, Wright JS, Hamm LF, Lui K, Newlin K et al. Increasing Cardiac Rehabilitation Participation From 20% to 70%: A Road Map From the Million Hearts Cardiac Rehabilitation Collaborative. Mayo Clinic Proceedings. 2017;92(2):234–42. DOI: 10.1016/j.mayocp.2016.10.014
45. Lubinskaya E.I., Nikolaeva O.B., Demchenko E.A. Clinical and social effectiveness of comprehensive cardiac rehabilitation program in patient after coronary artery bypass surgery. Bulletin of the Russian Military Medical Academy. 2012;1(37):218–23.
46. Ministry of Health of the Russian Federation. Order N 788n from 31.07.2020 ‘ On approval of the Procedure for the organization of medical rehabilitation of adults’. Registration number 60039 September 25, 2020. Av. at: http://publication.pravo.gov.ru/Document/View/0001202009250036.
Review
For citations:
Pogosova N.V. The importance of cardiorehabilitation in the era of modern treatment of cardiovascular diseases. Kardiologiia. 2022;62(4):3-11. (In Russ.) https://doi.org/10.18087/cardio.2022.4.n2015
Views:
1604
Email this article 
Post a Comment 
