Participation in cardiac rehabilitation after hospitalisation for heart failure: a report from the BIO-HF registry

Objective: Participation in cardiac rehabilitation (CR) after hospitalisation for heart failure (HF) is estimated to be low, but specific data for Belgium are lacking. Therefore, we wanted to evaluate attendance after HF hospitalisation compared to patients after cardiac surgery or acute coronary syndrome (ACS). Moreover, the improvement in exercise capacity was compared with the other patient groups. Methods and results: Patients who were hospitalized for HF (n = 428), cardiac surgery (n = 358) or ACS (n = 467) in a single hospital, were prospectively included between January 2010 and May 2012. After hospitalisation for HF only 9% participated, compared to 29% after ACS and 56% after cardiac surgery. Non-participants in HF were older, more frequently women (P < 0.01) and had a better left ventricular ejection fraction (P < 0.05). In addition, they had more frequently atrial fibrillation and problems to walk independently (P < 0.01). At the start of the CR, HF patients had a worse clinical status and exercise capacity than patients after cardiac surgery or ACS (all P < 0.001). However, exercise training resulted in a significant improvement in each group separately (all P < 0.001) and the relative improvement in exercise capacity in HF was comparable with the other groups. Conclusions: Only 9% of HF patients participated in CR after hospitalisation. Age, female gender, a relatively well-preserved ventricular function and atrial fibrillation seem to impede attendance to CR. However, HF patients can have as much improvement in exercise capacity as other patient populations, suggesting that more effort is needed to increase participation in CR among HF patients