American Journal of Medicine and Medical Sciences 2012, 2(5): 89-95 DOI: 10.5923/j.ajmms.20120205.01 Quality of Life after Cardiac Rehabilitation for Patients with Heart Failure: 18 months follow-up Elias F. Porto 1 , Claudia Kümpel 1 , José R. Leite 2 , Aline A. Andrade 1 ,Natália C. Oliveira 3,4 , Leslie A. Portes 1,3,4,* 1 Physical Therapy Department, Universitary Clinic, Adventist Univesity of São Paulo (UNASP), Brazil 2 Clinicas Hospital from University of São Paulo Medical School, Brazil 3 Exercise Physiology Laboratory (LAFEX-UNASP), São Paulo, Brazil 4 Physical Education Department, Adventist University of São Paulo (UNASP), Brazil Abstract The aim of this study was to evaluate the effects of a supervised cardiac rehabilitation (CR) program on long- term quality of life (QoL) of patients with heart failure (HF).Methods: A sample of 21 HF patients, previously sedentary, NYHA II, was randomly divided into two groups: the CR group (N = 13) and the control group (CG = 8). The CR consisted of sessions of 120 minutes/day, 3 times/week,for 60 days. CR group performed their activities under supervision at a rehabilitation clinic, and CG received standard care and was instructed to exercise at home. All patients underwent a maximal symptom-limited test at the beginning and after 30 and 60 days of CR. QoL was monitored after 60-days, 6, 12 and 18 months of CR. Results:Two-way ANOVA for repeated measures, followed by Tukey’s test for statistical analysis showed significantimprovement in peak VO 2 at 30 and 60-days of CR (p<0.05). QoL improved after 60-days of CR and remained improved throughout the 18following months in the supervised CR group. The use of hospital emergency services became less frequent (p=0.023) and there was a trend for better survival after 18 months of follow-up (p=0.092).Conclusion: CR was effective upon cardiopulmonary and QoL aspects. Keywords Heart Failure, Cardiac Rehabilitation, Functional Capacity, Quality of life, Survival 1. Introduction Heart Failure (HF) is, in most of the cases, a status due to the evolution of a number of illnesses, such as arterial hypertension or high blood pressure, coronary heart disease (CHD), acute myocardial infarction (AMI), valvediseases and cardiac arrhythmic illnesses[1,2]. The main HF symptoms are dyspnea, physical activity intolerance and quality of life reduction[2,3]. HF represents the main cause for hospital admission in individuals aging 65 and beyond. It is a fact that HF prevalence is increasing, and among the factors that might be contributing to this situation we highlightthe increase in life expectancy of the general population and greater effectiveness of new drugs[4]. However, despite the advent of new drugs, mortality and morbidity indexes are still high in this type of affection[1,2]. Cardiac rehabilitation (CR) has become mandatory in HF patients. Objectives of CR include mortality and morbidityreduction, quality of life improvement and cos reduction[5-13]. * Corresponding author: leslie.portes@unasp.edu.br (Leslie A. Portes) Published online at http://journal.sapub.org/ajmms Copyright © 2012 Scientific & Academic Publishing. All Rights Reserved Several studies have already demonstrated the efficacy of exercise - based CR programs[7-11], but a meta - analysis of randomized controlled trials[12] has concluded that quality of life improves to similar levels in patients receiving CR and standard care.The aim of the present study was to evaluate the effectiveness of asupervised CR program in the quality of life of HF subjects, as compared to standard care. Success indicators were based on cardiorespiratory capacity analysis, functional capacity, quality of life, survival and/or mortality. 2. Methods The present study was based on a longitudinal prospective design composed by two phases: 1 st -supervised CR or non-supervised CR (control) for 60 days; and 2 nd - 18 months follow-up after CR. All procedures in the study were in conformation with resolution 196/96 of the Brazilian Health Council(http://conselho.saude.gov.br/resol ucoes/1996/Reso196.doc) and the declaration of Helsinki[14], and were approved by the local University ethics committee (protocol number: 004/2005). 2.1. Patients After discharge from hospital, 28 ma le patients