ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Cardiac rehabilitation in patients with reduced left ventricular function in Germany: insights from the multicentre MEDIAN Heart Failure Registry.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHeart failure with reduced ejection fraction (HFrEF) causes reduced functional capacity, impaired quality of life, and frequent rehospitalisation. Although guidelines recommend cardiac rehabilitation (CardRehab), referral rates remain low. The MEDIAN Heart Failure Registry evaluated short- and midterm outcomes of inpatient CardRehab in routine practice.
methodsA prospective multicentre registry included 808 patients with clinically stable HFrEF (LVEF ≤ 40%) undergoing inpatient cardiac rehabilitation across 17 German centres (2019-2020). Clinical outcomes-6-min walk test, bicycle ergometry, echocardiographic LVEF, NYHA class, NT-proBNP (subset), and patient-reported outcomes (KCCQ, HADS)-were assessed at admission, discharge, and 6 months post-discharge. A structured follow-up survey evaluated adherence to lifestyle changes and the sustainability of effects after the 22.8-day inpatient stay.
resultsA total of 808 patients (mean age, 65 years; 16.6% females) showed significant improvements in physical and psychosocial parameters. Mean LVEF increased from 31.1% (SD 9.0) to 35.9% (SD 10.7; p < 0.01), mean 6-min walk distance from 306 m (SD 136) to 388 m (SD 158; p < 0.01), and mean bicycle ergometry from 27.8 W (SD 15.4) to 49.5 W (SD 26.4; p < 0.01). Mean NT-proBNP decreased (p < 0.01). KCCQ and HADS scores improved significantly. Inpatient mortality rate during rehabilitation was 0.6% (5/808), and the rehospitalisation rate due to heart failure was 2.8% (23/808). There were two documented cancellations of rehabilitation. At 6-month follow-up, benefits remained stable with high adherence to recommended behaviours.
conclusionsCardiac rehabilitation was associated with improvements in physical capacity, left ventricular function, psychological well-being, and quality of life in patients with chronic heart failure, alongside low observed rehospitalisation rates during follow-up.
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