From the Guidelines
Cardiac training cannot heal damaged heart muscle, but it can significantly improve heart function and quality of life for those with heart damage. Once heart muscle cells (cardiomyocytes) die, as in a heart attack, they cannot regenerate or be repaired through exercise 1. However, cardiac rehabilitation and regular exercise can help strengthen the remaining healthy heart muscle, improve blood flow, reduce the workload on the heart, and enhance cardiovascular efficiency.
Key Benefits of Cardiac Rehabilitation
- Improves heart function and quality of life for those with heart damage
- Helps strengthen the remaining healthy heart muscle
- Improves blood flow and reduces the workload on the heart
- Enhances cardiovascular efficiency For patients with heart damage, a structured cardiac rehabilitation program typically begins with low-intensity activities (like walking) for 5-10 minutes daily, gradually increasing to 30-60 minutes of moderate exercise most days of the week, as supported by a study published in the Journal of the American College of Cardiology 1. This should always be done under medical supervision. Exercise benefits heart health by lowering blood pressure, improving cholesterol levels, enhancing insulin sensitivity, reducing inflammation, and promoting the development of collateral blood vessels that can improve blood supply to the heart. While exercise cannot reverse existing damage, it can prevent further damage and help the heart adapt to function better despite the injury. According to a review published in Nature Reviews Cardiology, cardiac rehabilitation is a complex intervention that includes exercise training, physical activity promotion, health education, cardiovascular risk management, and psychological support, personalized to the individual needs of patients with diagnosed heart disease 1.
From the Research
Cardiac Training and Damaged Heart Muscle
- Cardiac rehabilitation training has been shown to improve cardiac function indicators and self-care ability in patients with heart disease 2.
- Exercise training is strongly recommended in patients with chronic stable heart failure, with moderate-intensity aerobic continuous training being the best established training modality 3.
- High-intensity interval exercise training (HIIT) has been found to exert larger improvements in exercise capacity compared to moderate-continuous exercise training in patients with heart failure 3.
- Cardiac rehabilitation combining exercise training and psycho-educational intervention can improve exercise capacity, quality of life, general and mental health in patients with implanted electronic devices such as pacemakers or implantable cardioverter defibrillators 4.
Effects of Cardiac Training on Heart Muscle
- Cardiac rehabilitation training can effectively improve patient's cardiac function indicators, such as left ventricular ejection fraction, and reduce the incidence of cardiovascular disease 2.
- Exercise-based training is a core component of primary and secondary prevention, and should involve healthy carriers of cardiovascular risk factors and patients with cardiomyopathy 5.
- Regular exercise has been demonstrated to improve metabolic and hemodynamic conditions in both asymptomatic risk factor carriers and cardiac patients 5.
Limitations and Future Directions
- Further large-scale studies are needed to evaluate the most appropriate management and demonstrate definitively the role of cardiac rehabilitation in patients with heart disease 4, 2.
- Large-sample, multicenter, and long-term randomized controlled trials are needed to strengthen the findings of the study on cardiac rehabilitation training 2.