Impact of phase II Cardiac Rehabilitation Program: a retrospective observational study
C Oliveira Ferreira, B Rocha, F Vilela, J Faria, S Fernandes, M Dias, I Conde, C Galvao, C OliveiraAbstract
Introduction
Cardiac rehabilitation programs (CRP) are multidisciplinary interventions designed for patients with cardiovascular disease, aiming to enhance exercise tolerance, functional capacity and long-term prognosis. Despite their well-established benefits, participation and adherence rates remain suboptimal, and the magnitude of physiological improvement can vary depending on baseline characteristics and program duration. This study aimed to assess the impact of a phase II CRP on functional capacity and cardiac autonomic regulation parameters in patients with established heart disease.
Methods
A retrospective observational study was conducted on 124 patients who participated in the CRP between June 2017 and April 2025. ociodemographic, clinical, analytical, and exercise stress test data - including functional capacity and cardiac autonomic regulation parameters - were collected at the beginning and at the end of the program.
Results
The cohort presented a mean age of 50 ± 12 years and 31 (25%) patients were female. The main motive for referral to the CRP was ischemic heart disease (n= 105, 84.5%). The median number of cardiac rehabilitation sessions was 30 (IQR= 18) and mean left ventricle ejection fraction was 45.78 ±11.8%. Sixteen patients (12.9%) simultaneously followed in an advanced heart failure consultation. A statistically significant improvement was observed in METs achieved (8.05 ± 2.46 vs. 9.06 ± 2.28; p < 0.001), chronotropic index (65.6 ± 18.7 vs. 69.0 ± 18.6; p = 0.015), and exercise test duration (6:40 ± 3:58 vs. 9:00 ± 3:55 min; p < 0.001). No significant changes were found in NYHA functional class or body mass index.
Conclusion
Participation in a structured phase II cardiac rehabilitation program was associated with significant improvements in exercise capacity and autonomic function, as evidenced by higher METs, longer exercise duration, and enhanced chronotropic response. These findings highlight the effectiveness of supervised rehabilitation in promoting functional recovery, even among patients with reduced left ventricular function. The absence of significant changes in NYHA class or body mass index underscores the need for complementary strategies targeting lifestyle modification and long-term adherence to achieve broader clinical benefits.