Gempel Sabine, Kologie Jenna, Wright Taylor, Decinti Destini, Cahalin Lawrence
Department of Physical Therapy, Miller School of Medicine, University of Miami, Coral Gables, FL 33146, USA.
Department of Cardiac Rehabilitation, University of Miami Hospital, Miami, FL 33136, USA.
J Clin Med. 2025 May 29;14(11):3815. doi: 10.3390/jcm14113815.
: The prevalence of heart failure with preserved ejection fraction (HFpEF) is expected to surpass that of heart failure with reduced ejection fraction (HFrEF), yet it remains under-researched. Compared to HFrEF, patients with HFpEF have similarly poor survival rates, physical impairments, and quality of life (QOL) and similar improvements following exercise training. However, Medicare currently excludes coverage for cardiopulmonary rehabilitation (CR) for HFpEF. The purpose of this study was to evaluate the impact of HF at baseline and the effects of CR in both subtypes. : Ninety-nine patients (forty-three with HFrEF and fifty-six with HFpEF) who completed CR were included. Demographic data and outcome measures were assessed pre- and post-CR, including weight, body mass index (BMI), 5x-sit-to-stand (5xStS), timed-up-and-go (TUG), 6-minute walk test (6MWT), Ferrans and Powers Quality of Life (F&P QOL), waist circumference, BERG balance, and Patient Health Questionnaire-9 (PHQ-9). Independent and paired t-tests were performed with statistical significance set at < 0.05. : At baseline, compared to patients with HFrEF, patients with HFpEF were older with a significantly lower 6MWT distance (350.6 m vs. 299.6 m), lower BERG balance scores (52/56 vs. 49/56, respectively), and a 5xSTS score indicating a fall risk (16.9 ± 6.5). Following CR, both groups had significant improvements in all functional and self-reported outcome measures ( < 0.001), with no significant differences between HF subtypes. Patients with HFpEF also had a significant improvement in waist circumference. : Compared to patients with HFrEF, patients with HFpEF presented with similar or greater impairments and had similar or greater improvements following CR. These results underscore the effectiveness of CR for HFpEF management and the need for insurance coverage.
射血分数保留的心力衰竭（HFpEF）的患病率预计将超过射血分数降低的心力衰竭（HFrEF），但其研究仍不足。与HFrEF相比，HFpEF患者的生存率、身体功能障碍和生活质量（QOL）同样较差，运动训练后的改善情况也相似。然而，医疗保险目前不涵盖HFpEF的心肺康复（CR）。本研究的目的是评估基线时心力衰竭的影响以及CR对两种亚型的作用。：纳入了99名完成CR的患者（43名HFrEF患者和56名HFpEF患者）。在CR前后评估人口统计学数据和结局指标，包括体重、体重指数（BMI）、5次坐立试验（5xStS）、计时起立行走试验（TUG）、6分钟步行试验（6MWT）、费兰斯和鲍尔斯生活质量量表（F&P QOL）、腰围、伯格平衡量表和患者健康问卷-9（PHQ-9）。进行独立样本t检验和配对t检验，设定统计学显著性为<0.05。：在基线时，与HFrEF患者相比，HFpEF患者年龄更大，6MWT距离显著更低（350.6米对299.6米），伯格平衡量表得分更低（分别为52/56对49/56），5xStS得分表明存在跌倒风险（16.9±6.5）。CR后，两组在所有功能和自我报告的结局指标上均有显著改善（<0.001），HF亚型之间无显著差异。HFpEF患者的腰围也有显著改善。：与HFrEF患者相比，HFpEF患者存在相似或更严重的功能障碍，CR后的改善情况也相似或更大。这些结果强调了CR对HFpEF管理的有效性以及保险覆盖的必要性。
