{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:34:14Z","timestamp":1787960054478,"version":"build-2784847793"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T00:00:00Z","timestamp":1539302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["1127917N"],"award-info":[{"award-number":["1127917N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009542","name":"Limburg Sterk Merk","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009542","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009550","name":"Universiteit Hasselt","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009550","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovascular Therapeutics"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Both cardiac resynchronization therapy (CRT) and Multidisciplinary Cardiac Rehabilitation (CR) beneficially influence symptomatic status, exercise capacity, quality of life, and heart failure readmission rates. However, the interaction between both therapies remain incompletely addressed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive CRT patients implanted in a single tertiary care center were retrospectively analyzed. Patients were dived according to the participation in a structured CR\u2010program following CRT\u2010implant. The effect on functional status (New York Heart Association; NYHA\u2010class), reverse remodeling (change in left ventricular ejection fraction; LVEF), and the combined endpoint of heart failure readmission and all\u2010cause mortality was assessed after multivariate correction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 655 patients were analyzed of whom 223(34%) did and 432(66%) did not participate in a structured multidisciplinary CR\u2010program following implant. No adverse events relating to exercise training occurred during the CR\u2010program. Patients who participated in the CR\u2010program had a more pronounced improvement in NYHA\u2010class at 6\u2010months (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.006), even after multivariate correction (\u03b2\u00a0=\u00a0\u22120.144; 95% CI\u00a0=\u00a0[\u22120.270; \u22120.018]; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.025). Maximal workload and VO2max on CPET at 6\u00a0months improved significantly even after adjustment (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001, respectively <jats:italic>P<\/jats:italic>\u00a0=\u00a00.017). At 6\u2010months, CR associated with more improvement in LVEF (+11.9\u00a0\u00b1\u00a013 vs +14.5\u00a0\u00b1\u00a011; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.008), however, this relationship was lost after multivariate correction (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.136). During 36\u00a0\u00b1\u00a022\u00a0months follow\u2010up, patients in the CR group had a higher event\u2010free survival for the combined endpoint (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), even after multivariate correction (adjusted HR\u00a0=\u00a00.547; CI\u00a0=\u00a00.366\u20100.818; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Following CRT\u2010implant, the participation in a structured CR\u2010program is safe and beneficially influences symptomatic response and clinical outcome. The beneficial effects of exercise training are potentially independent and additive to the beneficial reverse remodeling effect induced by CRT itself.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1755-5922.12467","type":"journal-article","created":{"date-parts":[[2018,9,22]],"date-time":"2018-09-22T01:41:07Z","timestamp":1537580467000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Effect of multidisciplinary cardiac rehabilitation on the response to cardiac resynchronization therapy"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6036-2113","authenticated-orcid":false,"given":"Pieter","family":"Martens","sequence":"first","affiliation":[{"name":"Department of Cardiology Ziekenhuis Oost\u2010Limburg Genk Belgium"},{"name":"Doctoral School for Medicine and Life Sciences Hasselt University Diepenbeek 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