Cardiac rehabilitation outcomes in women with chronic heart failure: mood, fitness, and exercise safety.
INTRODUCTION
Chronic heart failure (CHF) is a leading cause of morbidity in the industrialized world; both men and women are affected in significant numbers. However, women are underrepresented in heart failure literature, and there is limited evidence of their cardiac rehabilitation outcomes. The purpose of this study was to examine the efficacy of a cardiac rehabilitation program in female CHF patients.


METHODS
In a prospective cohort study, 60 female CHF subjects (median age, 59 years; median ejection fraction, 30%) were compared with 172 male CHF subjects (median age, 60 years; median ejection fraction, 27%), who completed an outpatient cardiac rehabilitation program. Self-reported exercise levels and intensity, fitness (6-minute walk test [6MWT]), and depressed mood (Cardiac Depression Scale) were recorded and compared at admission and discharge. Questionnaires were also re-administered at patient review conducted 3 months postdischarge.


RESULTS
Both female and male subjects made significant improvements in exercise levels (P < .05), exercise intensity (P < .001), fitness (P < .001), and mood (P < .001) during rehabilitation. Women showed significantly greater improvement in 6MWT results by discharge (P = .007) compared with men. At discharge, fewer women than men (78% vs 88%) reported exercising to adequate levels (≥ 150 minutes/week), but this had reversed at 3 months postdischarge.


CONCLUSIONS
Women with heart failure demonstrate similar patterns of improvement during cardiac rehabilitation compared with men and, in fact, show greater improvements in fitness and longer term exercise levels. Low to moderate intensity cardiac rehabilitation is both safe and effective in this group.