{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T11:51:46Z","timestamp":1790596306362,"version":"4.1.0"},"reference-count":58,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,6,8]],"date-time":"2019-06-08T00:00:00Z","timestamp":1559952000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Eur J Prev Cardiolog"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In heart failure with reduced left ventricular ejection fraction (HFrEF) patients the effects of exercise-based cardiac rehabilitation on top of state-of-the-art pharmacological and device therapy on mortality, hospitalization, exercise capacity and quality-of-life are not well established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The design of this study involved a structured review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Evaluation of randomised controlled trials of exercise-based cardiac rehabilitation in HFrEF-patients with left ventricular ejection fraction \u226440% of any aetiology with a follow-up of \u22656 months published in 1999 or later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 12,229 abstracts, 25 randomised controlled trials including 4481 HFrEF-patients were included in the final evaluation. Heterogeneity in study population, study design and exercise-based cardiac rehabilitation-intervention was evident. No significant difference in the effect of exercise-based cardiac rehabilitation on mortality compared to control-group was found (hazard ratio 0.75, 95% confidence interval 0.39\u20131.41, four studies; 12-months follow-up: relative risk 1.29, 95% confidence interval 0.66\u20132.49, eight studies; six-months follow-up: relative risk 0.91, 95% confidence interval 0.26\u20133.16, seven studies). In addition there was no significant difference between the groups with respect to \u2018hospitalization-for-any-reason\u2019 (12-months follow-up: relative risk 0.79, 95% confidence interval 0.41\u20131.53, four studies), or \u2018hospitalization-due-to-heart-failure\u2019 (12-months follow-up: relative risk 0.59, 95% confidence interval 0.12\u20132.91, four studies; six-months follow-up: relative risk 0.84, 95% confidence interval 0.07\u20139.71, three studies). All studies show improvement of exercise capacity. Participation in exercise-based cardiac rehabilitation significantly improved quality-of-life as evaluated with the Kansas City Cardiomyopathy Questionnaire: (six-months follow-up: mean difference 1.94, 95% confidence interval 0.35\u20133.56, two studies), but no significant results emerged for quality-of-life measured by the Minnesota Living with Heart Failure Questionnaire (nine-months or more follow-up: mean difference \u20134.19, 95% confidence interval \u201310.51\u20132.12, seven studies; six-months follow-up: mean difference \u20135.97, 95% confidence interval \u201316.17\u20134.23, four studies).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No association between exercise-based cardiac rehabilitation and mortality or hospitalisation could be observed in HFrEF patients but exercise-based cardiac rehabilitation is likely to improve exercise capacity and quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2047487319854140","type":"journal-article","created":{"date-parts":[[2019,6,8]],"date-time":"2019-06-08T12:36:00Z","timestamp":1559997360000},"page":"929-952","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":135,"title":["Exercise-based cardiac rehabilitation in patients with reduced left ventricular ejection fraction: The Cardiac Rehabilitation Outcome Study in Heart Failure (CROS-HF): A systematic review and meta-analysis"],"prefix":"10.1093","volume":"27","author":[{"given":"Birna","family":"Bjarnason-Wehrens","sequence":"first","affiliation":[{"name":"Institute for Cardiology and Sports Medicine, German Sport University Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Nebel","sequence":"additional","affiliation":[{"name":"Hermann-Albrecht-Klinik Mettnau, 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