Time to Include Balance Training in the Cardiac Rehabilitation Programs of Patients with Heart Failure with Preserved Ejection Fraction

The burden of heart failure exerts a significant personal, social and economic impact not only on patients and their families but also on society (including health care systems). Heart failure is a chronic, progressive condition affecting a huge amount of individuals worldwide (>37.7 million cases estimated in 2010). It is characterized by typical symptoms (e.g. breathlessness and fatigue) that may be accompanied by signs (e.g. peripheral edema) caused by cardiac abnormalities – structural and/or functional –, resulting in reduced cardiac output and/or elevated intracardiac pressures at rest or during stress. Heart failure has been categorized in heart failure with preserved (HFpEF), mid-range (HFmrEF) and reduced ejection fraction (HFrEF) according to the left ventricular ejection fraction.

Heart failure with preserved ejection fraction has become an increasingly recognized phenotype; despite being primarily considered a condition that affects old-age individuals, it represents approximately half of all cases of heart failure. ^, Despite the available pharmacological and device therapies, heart failure patients’ prognosis, quality of life, and 5-year survival remain poor and similar across all heart failure categories. ^–

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