{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T09:12:18Z","timestamp":1790241138272,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100014597","name":"Universidade da Coru\u00f1a","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014597","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Heart failure with reduced ejection fraction leads to exercise intolerance due to central and peripheral dysfunction. Improvements in exercise performance are not fully captured by traditional measures like peak oxygen consumption alone. A 57\u2010year\u2010old male with a complex cardiac medical history of hypertrophic cardiomyopathy with left ventricle non\u2010compaction, Wolff\u2010Parkinson\u2010White syndrome, transient ischemic stroke, and heart failure with reduced ejection fraction with an implanted cardiac resynchronization therapy defibrillator underwent cardiac rehabilitation. Cardiopulmonary exercise testing revealed a non\u2010proportional improvement in peak oxygen consumption (0.3 METs, 9%) versus peak workload (48 W, 61%). Gross mechanical economy and efficiency improved at all physiological thresholds: at ventilatory threshold by 11%, at respiratory compensation point by 60% and 41%, and at peak oxygen consumption by 47% and 33%, respectively. Mechanical economy and mechanical efficiency should be measured and reported for assessing rehabilitation outcomes in heart failure with reduced ejection fraction.<\/jats:p>","DOI":"10.1002\/ccr3.71315","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T04:46:53Z","timestamp":1760676413000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Role of Mechanical Economy and Efficiency as Key Drivers of Cardiac Rehabilitation Exercise Performance Improvement in a Patient With Heart Failure and an Implanted\n                    <scp>CRT<\/scp>\n                    \u2010D: A Case Report and Literature Review"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1727-9135","authenticated-orcid":false,"given":"Javier","family":"Loureiro Diaz","sequence":"first","affiliation":[{"name":"Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education Universidade da Coru\u00f1a  Oleiros Spain"},{"name":"Cardiac Rehabilitation Department Heart Hospital. Hamad Medical Corporation  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7417-3559","authenticated-orcid":false,"given":"Praveen Jayaprabha","family":"Surendran","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Department Heart Hospital. Hamad Medical Corporation  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1153-6305","authenticated-orcid":false,"given":"Prasobh","family":"Jacob","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Department Heart Hospital. Hamad Medical Corporation  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6251-8841","authenticated-orcid":false,"given":"Salma","family":"Chbib","sequence":"additional","affiliation":[{"name":"Pharmacy Department Heart Hospital. 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Hamad Medical Corporation  Doha Qatar"},{"name":"Research Laboratory \u201cHeart Failure, LR12SP09\u201d Hospital Farhat HACHED of Sousse  Sousse Tunisia"},{"name":"Healthy Living for Pandemic Event Protection (Hl\u2010Pivot) Network  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8968-3967","authenticated-orcid":false,"given":"Liam David","family":"Foster","sequence":"additional","affiliation":[{"name":"Rehabilitation Department The View Hospital  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Department Heart Hospital. 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