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Background/Objective: Over the past two decades, the utilization of virtual care in rehabilitation has witnessed a significant surge; this is owing to the widespread availability of technological tools and the global impact of the COVID-19 pandemic. As a result, discussions surrounding the relevance and benefits of telerehabilitation have gained prominence among practitioners, who continually seek to enhance patient care while maintaining high standards of quality. Associated with these discussions are concerns over being able to provide care in an ethical way, as well as addressing equity issues that might be hindered or improved via telerehabilitation. To address the ethical and equity concerns around telerehabilitation, a series of five parallel rapid reviews of the scientific literature were conducted, focusing on different rehabilitation fields: physiotherapy and occupational therapy (1); speech therapy and audiology (2); psychology and neuropsychology (3); and in two age groups: older adults (4); and pediatrics and young adults (5). The objective of this series of rapid reviews is to evaluate the evidence presented regarding telerehabilitation; identifying and recommending best practices especially in the realm of ethics and equity. Methods: Medline; CINAHL; and EMBASE were searched between 2010 and 2023 for English or French-language reviews (2010–2020) and individual studies (2020–2023) pertaining to telerehabilitation and these fields of interest. Data were extracted following a standardized form focusing on: outcomes; findings; quality assessment/biases; limitations; and discussion of ethical and equity concerns. Results: The results are presented according to the most relevant themes, which include: findings; strengths; limitations; and ethical/equity considerations. Conclusions: This research presents a methodology rarely published before, on how to conduct multiple parallel rapid reviews on the theme of telerehabilitation, based on different rehabilitation fields and age groups. This research will shape future guidelines and standards in applying ethical and equity standards in telerehabilitation. [ABSTRACT FROM AUTHOR]

Background: Heart rate recovery (HRR) is a marker of vagal tone that is a powerful predictor of mortality in patients with coronary artery disease., Design: This study aims at evaluating the effects of long-term exercise training on HRR after acute myocardial infarction (AMI), in order to clarify whether prolonged exercise training could maintain a long-term improvement of HRR., Methods: Forty-four patients after AMI were enrolled in a 3-month hospital-based exercise training programme. At the end, patients were subdivided into two groups: group A (n=22), patients discharged with a specific home-based exercise training programme and instructions for improving leisure-time physical activity; group B (n=22), patients discharged with generic instructions to maintain physical activity. All patients underwent a cardiopulmonary exercise test before, at the end of 3 months exercise training and at 6 months follow-up., Results: At the end of the hospital-based exercise training programme we observed an increase in peak oxygen consumption [VO2peak; from 13.9+/-3.6 to 18+/-2.7 ml/kg per min (A) and from 14.1+/-3.9 to 17.9+/-2.1 ml/kg per min (B), P<0.001] and in HRR [from 17.1+/-1.8 to 23.4+/-1.4 beats/min (A), and from 18.8+/-2.1 to 24.3+/-1.9 beats/min (B), P<0.001]. At 6 months' follow-up we observed a further improvement in VO2peak (from 18.0+/-2.7 to 20.3+/-2.7 ml/kg per min, P<0.001) and in HRR (from 23.4+/-1.4 to 27.8+/-2.1 beats/min, P<0.001) in group A, but a significant decrease in VO2peak and in HRR in group B (P<0.001)., Conclusion: Long-term exercise training is useful for maintaining or improving the beneficial results of the standard 3-month exercise training programme on cardiovascular capacity and HRR. This observation may bear beneficial prognostic effects on patients after AMI.

Introduction: N-terminal-pro-brain (B-type) natriuretic peptide (NT-pro-BNP) is a peptide hormone released from ventricles in response to myocyte stretch. The aim of the study was to investigate the influence of exercise training on plasma NT-pro-BNP to verify if this parameter could be used as a biological marker of left ventricular remodelling in myocardial infarction patients undergoing an exercise training programme., Methods: Forty-four patients after myocardial infarction were enrolled into a cardiac rehabilitation programme, and were randomized in two groups of 22 patients each. Group A patients followed a 3-month exercise training programme, while group B patients received only routine recommendations. All patients underwent NT-pro-BNP assay, and cardiopulmonary exercise test before hospital discharge and after 3 months., Results: In Group A, exercise training reduced NT-pro-BNP levels (from 1498+/-438 to 470+/-375 pg/ml, P=0.0026), increased maximal (VO2peak+4.3+/-2.9 ml/kg per min, P<0.001; Powermax+38+/-7, P<0.001) exercise parameters and work efficiency (Powermax/VO2peak+1.3+/-0.4 Power/ml per kg per min, P<0.001); there was also an inverse correlation between changes in NT-pro-BNP levels and in VO2peak (r=-0.72, P<0.001), E-wave (r=-0.51, P<0.001) and E/A ratio (r=0.59, P<0.001). In group B, at 3 months, no changes were observed in NT-pro-BNP levels, exercise and echocardiographic parameters., Conclusion: Three months exercise training in patients with moderate left ventricular systolic dysfunction after myocardial infarction induced a reduction in NT-pro-BNP levels, an improvement of exercise capacity and early left ventricular diastolic filling, without negative left ventricular remodelling. Whether the reduction of NT-pro-BNP levels could be useful as a surrogate marker of favourable left ventricular remodelling at a later follow-up remains to be further explored.

Background: This study was addressed to verify if Telecardiology (TC) improves the results of Cardiac Rehabilitation in patients following a home-based Cardiac Rehabilitation Program (CRP) after acute myocardial infarction (AMI)., Materials and Methods: We studied three groups of patients after AMI: Group A (control group): 15 patients, who followed a standard in-hospital CRP of 3 weekly sessions of 2 months duration; Group B (study group): 15 patients, who were enrolled in a home-based CRP of similar duration and were monitored by TC with the aid of an ecg-device (Sorin Life Watch CG 6106); Group C (second control group): 15 patients, who followed a home-based CRP without ecg-monitoring by TC. All patients performed a symptom-limited exercise testing at the beginning of the CRP. Psychometric data (STAI-Y1, STAI-Y2, BDI) were also evaluated. At the end of the CRP all patients underwent repeated exercise testing and psychometric evaluation., Results: TC applied to the home-based CRP was associated with a good compliance to the program. Compared to Group C, in Group B we observed an increase of maximal heart rate, exercise duration, maximal work-load, and an improvement of anxiety, a trend to reduction of depression, and an improvement of quality of life. These results were very similar to Group A patients following a hospital-based CRP., Conclusions: TC improves compliance, functional capacity and psychological profile of patients undergoing a home-based CRP, compared to patients enrolled in a home-based CRP without ecg-monitoring by Telecardiology.

Objects: This study aims to evaluate the influence of household smokers and of a prolonged, comprehensive home-based Cardiac Rehabilitation Program (CRP) on patient's long term smoking behaviour after AMI., Methods: 164 male post-AMI patients, all smokers until the day of AMI, were subdivided into three groups: Group A (n=54): patients with recent AMI, discharged from hospital without enrolment in CRP; Group B (n=55): similar to Group A but enrolled in an 8 weeks hospital-based CRP and then discharged home with routine care; Group C (n=55) enrolled in an 8 weeks hospital-based CRP followed by a further 10 months of formal home-based CRP, with scheduled hospital follow-up visits., Results: Smoking resumption at 12 months was influenced by the presence of household smokers (HS): 38% of patients with HS resumed smoking compared to 27% of patients without HS (p <0.01). Adherence to a CRP was inversely correlated to smoking resumption: there were fewer smoking patients at 12 months from AMI in Group C than in Groups A or B (11% in C vs. 29% and 55% in B and A, respectively, p <0.001)., Conclusions: Long term maintenance of CRP seems to be the best way to achieve a reduction of long term smoking habit and maintain adherence to prescription in patients after AMI. Counselling and behavioural intervention should also be extended to family members in order to maximize the benefit of secondary prevention.

We report a case of a 68-year-old patient, admitted with diagnosis of aneurysm of the descending thoracic aorta to the Department of Cardiac Surgery, where he underwent percutaneous endovascular application of 4 endoprostheses in the descending thoracic aorta. After antibiotic prophylaxis and hemodynamic stabilization, the patient was admitted to the Cardiac Rehabilitation Unit for the management of the of postoperative course and undergo a program of cardiac rehabilitation. Five days following admission and before starting physical training, the patient developed fever associated with neutrophil leukocytosis, strong activation of inflammatory markers and sideropenic anemia, compatible with post-implantation inflammatory syndrome. Significant hypokalemia also occurred. Further investigations showed left cortical-suprarenal adenoma. The inflammatory state relapsed spontaneously and the patient was discharged with indication to undergo an endocrinologic consultation.

Purpose: Despite evidence of efficacy, the effectiveness of telerehabilitation in real-world clinical settings is still largely unknown. Telerehabilitation requires a substantial transformation of the organization and delivery of traditional services. Considering that a virtual setting can create unique challenges for providing physiotherapy services and given the physical and potential hands-on nature of evidence-based assessments and interventions, it is important to investigate what injured workers think of receiving physiotherapy care via telerehabilitation and to examine if rehabilitation needs are adequately met., Methods: A qualitative interpretive description study was conducted to explore the perspectives and experiences of 17 injured workers receiving physiotherapy via telerehabilitation. Data were collected through semi-structured interviews with participants from three provinces in Western Canada and analysed using thematic analysis. Qualitative rigour criteria of epistemological integrity, analytic logic, interpretive authority, and representative credibility were considered throughout this study., Results: Implementation of telerehabilitation during the COVID-19 pandemic resulted in mixed perceptions from injured workers. Some viewed telerehabilitation as a resourceful option for providing services during the pandemic lockdown, resulting in maintained communications while overcoming barriers to services (e.g., rural/remote workers, transportation barriers, etc.). However, many thought telerehabilitation was inferior to in-person therapy for assessment and when 'hands-on' interaction was needed. Many believed a hybrid option may be ideal now that pandemic restrictions are lifted, with telerehabilitation supplementing in-person physiotherapy when needed., Conclusions: Telerehabilitation was viewed as a resourceful option during the pandemic and in certain clinical situations (e.g., rural/remote). Workers should be able to make informed choices about service delivery format., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests. Ethical Approval: Ethics approval was obtained from the research ethics boards of the Université de Montréal (CERSES-21-064-D), University of Alberta (Pro00110034), University of British Columbia (H21-01559) and University of Saskatchewan (reciprocal agreement with University of Alberta—Beh 2956). Human and Animal Participant: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed Consent: All participants provided informed consent prior to participating in the study., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background and Objectives Exercise-based cardiac rehabilitation (CR) programs increase physiological function. However, it is not yet clear which feature of exercise is most effective in improving important physiological performance indicators in heart patients. Therefore, this study aimed to compare the effects of high-intensity interval training (HIT) and moderate-intensity continuous training (MCT) on the metabolic equivalent of tasks (METs), submaximal myocardial oxygen consumption (MVO2submax), and heart rate recovery (HRR) of heart patients after coronary artery bypass graft (CABG) surgery. Subjects and Methods Twenty-four post-CABG patients (15 males and 9 females) with a mean age of 60.75 ± 3.16 years and a mean body mass index (BMI) of 28.40 ± 1.09 kg/m² were randomly divided into three groups of HIT, MCT, and control group (CG). The training groups (HIT and MCT) trained for eight weeks, three sessions per week, and 45 min per session. The research variables (METs, MVO2submax, and HRR) were measured and compared in two stages before and after eight-weeks of CR programs. Results After eight weeks of CR programs, patients in both training groups showed a significant improvement in METs, MVO2submax, and HRR (P<0.05), and the HIT group showed significantly greater improvement in METs (P=0.001) and HRR (P=0.001) compared to the MCT group. Moreover, the MCT group showed a significantly more improvement in MVO2submax (P=0.001) than the HIT group. In addition, no cardiovascular adverse events related to HIT or MCT occurred during the implementation of the study. Conclusion According to the results of the present study, HIT seems to be more effective than MCT in improving METs and HRR of post-CABG patients and is safe as well. [ABSTRACT FROM AUTHOR]

Previous meta-analyses have shown that high-intensity interval training (HIIT) is more suitable than moderate continuous training (MCT) for improving peak oxygen uptake (VO2peak) in patients with coronary artery disease. However, none of these meta-analyses have tried to explain the heterogeneity of the empirical studies in optimizing cardiac rehabilitation programs. Therefore, our aims were (a) to estimate the effect of MCT and HIIT on VO2peak, and (b) to find the potential moderator variables. A search was conducted in PubMed, Scopus, and ScienceDirect. Out of the 3,110 references retrieved, 29 studies fulfilled the selection criteria to be included in our meta-analysis. The mean difference was used as the effect size index. Our results showed significant enhancements in VO2peak after cardiac rehabilitation based on MCT and HIIT (mean difference = 3.23; 95% confidence interval [2.81, 3.65] ml·kg−1·min−1 and mean difference = 4.61; 95% confidence interval [4.02, 5.19] ml·kg−1·min−1, respectively), with greater increases after HIIT (p <.001). Heterogeneity analyses reached statistical significance with moderate heterogeneity for MCT (p <.001; I2 = 67.0%), whereas no heterogeneity was found for the effect of HIIT (p =.220; I2 = 22.0%). Subgroup analyses showed significant between-group heterogeneity of the MCT-induced effect based on the training mode (p <.001; I2 = 90.4%), the risk of a new event (p =.010; I2 = 77.4%), the type of cardiovascular event (p =.009; I2 = 84.8%), the wait time to start cardiac rehabilitation (p =.010; I2 = 76.6%), and participant allocation (p =.002; I2 = 89.9%). Meta-regressions revealed that the percentages of patients undergoing a revascularization procedure (B = −0.022; p =.041) and cardiorespiratory fitness at baseline (B = −0.103; p =.025) were inversely related to the MCT-induced effect on the VO2peak. [ABSTRACT FROM AUTHOR]

Left ventricular (LV) remodeling is a dynamic process, which is characterized by changes in ventricular size, shape, and wall thickness, thus altering myocardial geometry and function, and is considered as a negative prognostic factor in patients with heart failure (HF). Hypertension, type 2 diabetes (T2D), and obesity are strongly correlated with the development and the progression of LV remodeling, LV hypertrophy, and LV systolic and/or diastolic dysfunction. Indeed, the beneficial impact of exercise training on primary and secondary prevention of cardiovascular disease (CVD) has been well-established. Recent studies have highlighted that exercise training enhances functional capacity, muscle strength and endurance, cardiac function, and cardiac-related biomarkers among patients with established coronary artery disease (CAD) or HF, thus substantially improving their cardiovascular prognosis, survival rates, and need for rehospitalization. Therefore, in this review article, we discuss the evidence of LV remodeling in patients with cardiometabolic risk factors, such as hypertension, T2D, and obesity, and also highlight the current studies evaluating the effect of exercise training on LV remodeling in these patients. [ABSTRACT FROM AUTHOR]

There is a pandemic of physical inactivity that appears to parallel the widespread prevalence of cardiovascular disease (CVD). Yet, regular physical activity (PA) and exercise can play an important role not only in primary cardiovascular prevention but also in secondary prevention. This review discusses some of the main cardiovascular effects of PA/exercise and the mechanisms involved, including a healthier metabolic milieu with attenuation of systemic chronic inflammation, as well as adaptations at the vascular (antiatherogenic effects) and heart tissue (myocardial regeneration and cardioprotection) levels. The current evidence for safe implementation of PA and exercise in patients with CVD is also summarized. [ABSTRACT FROM AUTHOR]

Although shown to be effective in improving survival and quality of life in patients with cancer, some treatments are well-known causes of cardiotoxicity, such as anthracyclines, monoclonal antibodies against human epidermal growth factor receptor 2 (HER2) and radiotherapy. To prevent cardiovascular disease (CVD) in patients living with cancer, cardiologists and oncologists promoted the development of cardio-oncology, an interdisciplinary field which aims to further improving life expectancy in these patients. Cardio-oncology rehabilitation (CORE), through correction of risk factors, prescription of drug therapies and structured exercise programs, tries to improve symptoms, quality of life, cardiorespiratory fitness (CRF) and survival in patients with cancer. Different imaging modalities can be used to evaluate the real effectiveness of exercise training on cardiac function. Among these, the global longitudinal strain (GLS) has recently aroused interest, thanks to its high sensitivity and specificity for cardiac dysfunction detection due to advanced ultrasound programs. This review summarizes the evidence on the usefulness of GLS in patients with cancer undergoing cardiac rehabilitation programs. [ABSTRACT FROM AUTHOR]

The high health care costs and poor quality associated with heart failure have led to the development of remote patient monitoring (RPM or RM) systems and cost-effective disease management strategies. RM of cardiac implantable electronic devices (CIEDs) is the application of communication technology to patients carrying a pacemaker (PM), an implantable cardioverter defibrillator (ICD) for cardiac resynchronization therapy (CRT) or an implantable loop recorder (ILR). The aim of this study is to define and analyze the benefits of modern telecardiology to provide patients with remote clinical assistance especially for patients with implantable devices for early detection of the development of heart failure as well as the limitations inherent therein. Furthermore, the study examines the benefits of telemonitoring in chronic and cardiovascular diseases proposing holistic care. A systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses-PRISMA methodology. The results highlight that telemonitoring has augmented beneficial effects on clinical outcomes of heart failure, including, a reduction in mortality, heart failure hospitalization, all cause hospitalization and also an improvement in Quality of Life. [ABSTRACT FROM AUTHOR]

Heart failure (HF) is a chronic, progressive, and inexorable syndrome affecting worldwide billion of patients (equally distributed among men and women), with prevalence estimate of 1--3% in developed countries. HF leads to enormous direct and indirect costs, and because of ageing population, the total number of HF patients keep rising, approximately 10% in patients >65 years old. Exercise training (ET) is widely recognized as an evidence-based adjunct treatment modality for patients with HF, and growing evidence is emerging among elderly patients with HF. We used relevant data from literature search (PubMed, Medline, EMBASE) highlighting the epidemiology of HF; focusing on central and peripheral mechanisms underlying the beneficial effect of ET in HF patients; and on frail HF elderly patients undergoing ET. Since many Countries ordered a lockdown in early stages pandemic trying to limit infections, COVID-19 pandemic, and its limitation to exercise-based cardiac rehabilitation operativity was also discussed. ET exerts both central and peripheral adaptations that clinically translate into anti-remodeling effects, increased functional capacity and reduced morbidity and mortality. Ideally, ET programs should be prescribed in a patient-tailored approach, particularly in frail elderly patients with HF. In conclusion, given the complexity of HF syndrome, combining, and tailoring different ET modalities is mandatory. A procedural algorithm according to patient's baseline clinical characteristics [i.e., functional capacity, comorbidity, frailty status (muscle strength, balance, usual daily activities, hearing and vision impairment, sarcopenia, and inability to actively exercise), logistics, individual preferences and goals] has been proposed. Increasing long-term adherence and reaching the frailest patients are challenging goals for future initiatives in the field. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of tele-monitored cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation. Design: Single-centre, prospective, assessment-blinded, randomised controlled trial. Setting: Domiciliary rehabilitation with support from a tertiary care hospital. Subjects: One hundred patients who underwent ablation for atrial fibrillation were recruited. Interventions: Participants were randomly allocated to a 12-week standard rehabilitation treatment (control group) or a comprehensive, domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program (intervention group) in a 1:1 fashion. Main outcome measures: The primary endpoint was the improvement in VO2peak. The secondary outcomes included adherence, physical activity, beliefs related to cardiovascular disease and exercise self-efficacy. Results: Ninety-seven patients completed follow-up. The mean VO2peak increased significantly in both the intervention group (n = 49) (baseline vs 12 weeks: 19.1 ± 4.7 vs 27.3 ± 5.6 ml/(min kg), P < 0.01) and the control group (n = 48) (baseline vs 12 weeks: 18.7 ± 4.9 vs 22.9 ± 6.3 ml/(min kg), P < 0.01). The results of the between-group analysis of aerobic capacity were significantly in favour of the intervention group. During the 12-week program, patients in the intervention group exhibited better adherence than those in the control group. Moreover, self-reported physical activity improved more in the intervention group than in the control group, as did the beliefs related to cardiovascular disease and exercise self-efficacy (all P < 0.01). Conclusions: Our domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program could lead to a more significant improvements in physical fitness, adherence and health beliefs than standard cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation. [ABSTRACT FROM AUTHOR]

Background: Smoking cessation is an effective secondary prevention measure after acute coronary syndrome (ACS). We conducted a systematic review with the aim to better understand which patients have a greater propensity to quit smoking and the risk factors for continued smoking after ACS. Methods: We searched MEDLINE and EMBASE for studies that evaluated smoking cessation after ACS. The pooled rate of smoking cessation across included studies was performed. Random effects meta‐analysis for different variables and their association with smoking cessation was conducted. Results: A total of 39 studies with 11 228 patients were included in this review. The pooled rate of smoking cessation following ACS across 38 studies was 45.0%. Factors associated with greater likelihood of smoking cessation were attendance at cardiac rehabilitation (OR 1.90 95% CI 1.44‐2.51), married/not alone (OR 1.68 95% CI 1.32‐2.13), intention/attempt to quit smoking (OR 1.27 95% CI 1.11‐1.46), diabetes mellitus (OR 1.24 95% CI 1.03‐1.51) and hospitalised duration (OR 1.09 95% CI 1.02‐1.15). Variables associated with a lower likelihood of smoking cessation were depression (OR 0.57 95% CI 0.43‐0.75), chronic obstructive pulmonary disease/lung disease (OR 0.73 95% CI 0.57‐0.93), previous admission with acute myocardial infarction/cardiac admission (OR 0.61 95% CI 0.47‐0.80), cerebrovascular disease/transient ischaemic attack (OR 0.42 95% CI 0.30‐0.58) and unemployment (OR 0.37 95% CI 0.17‐0.80). Conclusions: The majority of smokers with an ACS continue to smoke after admission. Patients attending cardiac rehabilitation show increased odds of quitting while people who are depressed and those with chronic lung disease were less likely to quit smoking and should be targeted for intensive smoking cessation interventions. [ABSTRACT FROM AUTHOR]

Background: Exercise training in heart failure (HF) patients should be monitored to ensure patients' safety. Electrocardiographic (ECG) telemonitoring was used to assess the safety of hybrid comprehensive telerehabilitation (HCTR). Objective: Analysis of ECG recorded during HCTR in HF patients. Methods: The TELEREH-HF multicenter, randomized, controlled trial enrolled 850 HF patients with New York Heart Association class I-III and left ventricular ejection fraction of ≤40%. This subanalysis focuses on 386 patients (aged 62 ± 11 years, LVEF 31 ± 7%) randomized to HCTR. HCTR was telemonitored with a device allowing to record 16-s fragments of ECG and to transmit the data via mobile phone network to the monitoring center. Results: In 386 patients, 16,622 HCTR sessions were recorded and 66,488 ECGs fragments were evaluated. Sinus rhythm was present in 320 (83%) and permanent atrial fibrillation (AF) in 66 (17%) patients, respectively. The most common arrhythmias were ventricular and atrial premature beats, recorded in 76.4% and 27.7% of the patients, respectively. Non-sustained ventricular tachycardia (21 episodes in 8 patients) and paroxysmal AF episodes (6 in 4 patients) were rare. None of the analyzed demographic and clinical characteristics was predictive for onset of the new arrhythmias on exercise. Conclusion: Telerehabilitation in HF patients was safe without the evidence for symptomatic arrhythmias requiring discontinuation of telerehabilitation. Only one mildly symptomatic paroxysmal AF episode led to the short-term suspension of the training program. The most common arrhythmias were atrial and ventricular premature beats. These arrhythmias did not result in any changes in rehabilitation and therapy regimens. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this retrospective study is to evaluate the effectiveness of early cardiac rehabilitation on patients with heart failure following acute myocardial infarction. Methods: Two hundred and thirty-two patients who developed heart failure following acute myocardial infarction were enrolled in this study. Patients were divided into heart failure with reduced ejection fraction group (n = 54) and heart failure with mid-range ejection fraction group (n = 178). Seventy-eight patients who accepted a two-week cardiac rehabilitation were further divided into two subgroups based on major adverse cardiovascular events. Key cardio-pulmonary exercise testing indicators that may affect the prognosis were identified among the cardiac rehabilitation patients. Results: Early cardiac rehabilitation significantly reduced cardiac death and re-hospitalization in patients. There was more incidence of diabetes, hyperkalemia and low PETCO2 in the cardiac rehabilitation group who developed re-hospitalization. Low PETCO2 at anaerobic threshold (≤ 33.5 mmHg) was an independent risk factor for re-hospitalization. Conclusions: Early cardiac rehabilitation reduced major cardiac events in patients with heart failure following acute myocardial infarction. The lower PETCO2 at anaerobic threshold is an independent risk factor for re-hospitalization, and could be used as a evaluating hallmark for early cardiac rehabilitation. [ABSTRACT FROM AUTHOR]