Effects of a Rehabilitation Program on Immune Activation and Mood in Heart Failure Patients

Effects of a Multi-Modality Rehabilitation Program on Immune Activation, Depressive Symptoms and Quality of Life in Heart Failure Patients. A Pilot Study

The aim of this descriptive study is to examine potential changes regarding inflammatory cytokine levels, depressive symptoms and quality of life over the course of the 4-week inpatient rehabilitation program which includes a cassette of modalities including counseling, psychosocial education and supervised exercise training as a main pillar, and to further investigate if there are correlations between changes in immune regulation, depressive symptoms and quality of life.

Inclusion Criteria:

• Diagnosis of heart failure with reduced ejection fraction (HFREF) with an EF ≤ 45%, NYHA (New York Heart Association) I - III; ACC/AHA (American College of Cariology/ American Heart Association) stage C, irrespective of etiology
• Clinically stable patients without deterioration or hospitalization due to heart failure within the last 4 weeks
• Neuro-hormonal medication according to the ESC (European Society of Cardiology) guidelines for the treatment of chronic heart failure consisting of antagonists of the Renin-Angiotensin-Aldosterone System (RAAS) and beta-blockers as indicated.
• Ability to fully understand all elements of and sign the written informed consent before initiation of the study

Exclusion Criteria:

• Fluid retention of cardiac decompensation, necessitating i.v. diuretic therapy
• Myocardial infarction within the last 2 months
• Surgery including cardiovascular or valvular surgery within 3 Months
• Uncontrolled proinflammatory comorbidities (e.g. Diabetes mellitus HbA1c >9%, COPD ( chronic obstructive pulmonary disease) >II, active rheumatic diseases and autoimmune disorders)
• Current infectious diseases ( e.g. pneumonia, COPD exacerbations or urinary tract infections)
• Morbid obesity: BMI > 40
• Alcohol or drug abuse
• psychiatric disorders