# Cardiale revalidatie verbetert belastbaarheid bij hartfalenexacerbatie

*geplaatst 2026-10-01 · Hartfalen · Zhonghua xin xue guan bing za zhi · doi 10.3760/cma.j.cn112148-20260515-00320 · https://hartvaat.nl/2026/09/24/cardiale-revalidatie-verbetert-belastbaarheid-bij-hartfalenexacerbatie/*

Een retrospectieve cohortstudie onder 154 patiënten met een hartfalenexacerbatie toont dat gestandaardiseerde cardiale revalidatie naast conventionele therapie de fysieke prestaties en loopafstand (6MWT) significant verbetert. Hoewel het aantal MACE in de revalidatiegroep lager was (34% versus 49%), bereikte dit verschil geen statistische significantie (p=0,051). De Humanin/CRP-ratio correleerde negatief met het MACE-risico, maar heeft als enkelvoudige prognostische marker beperkte discriminerende waarde. De bevindingen ondersteunen de toevoeging van revalidatie aan de acute fase van hartfalen, maar bevestigen de klinische routine niet.

## English: [Effects of cardiac rehabilitation and predictive value of Humanin/CRP ratio in patients with acute exacerbation of chronic heart failure].

A single-center retrospective cohort study of 154 patients hospitalized for acute heart failure exacerbation found that adding a standardized rehabilitation program to standard care significantly improved physical performance and six-minute walk distance. Major adverse cardiovascular events at six months were numerically lower with rehabilitation (34% vs 49%), though this did not reach statistical significance (p=0.051). While a lower Humanin/CRP ratio was associated with higher MACE risk, its standalone predictive accuracy was limited by low specificity. These results support the integration of early rehabilitation in acute heart failure care, but larger randomized trials are needed to confirm hard clinical outcomes.

## Abstract (original, from the publication)

Objective: To evaluate the effects of a standardized rehabilitation protocol on physical performance, exercise tolerance, and prognosis in hospitalized patients with acute exacerbation of chronic heart failure (CHF), and to explore the clinical value of the serum Humanin (a mitochondria-derived peptide) to C-reactive protein (CRP) ratio in prognostic risk stratification. Methods: This non-randomized retrospective cohort study consecutively enrolled patients with acute exacerbation of CHF admitted to the Third Affiliated Hospital of Nanjing Medical University from March to November 2025. Patients were divided into a rehabilitation intervention group and a control group according to whether standardized rehabilitation was implemented. The rehabilitation intervention group received comprehensive management including active and passive exercise, respiratory muscle training, and nutritional support in addition to conventional pharmacological therapy. Baseline data including age and sex were collected, and serum Humanin and CRP levels were measured to calculate the Humanin/CRP ratio. Physical performance at discharge was assessed using the short physical performance battery score and the 6-minute walk test. Patients were followed up for 6 months after discharge, and the incidence of major adverse cardiovascular events (MACE) was compared between the two groups. Multivariate Cox regression was used to analyze independent risk factors for MACE. The key variable identified from the multivariate Cox regression model (Humanin/CRP ratio) was used to construct a receiver operating characteristic curve. Kaplan-Meier survival curves were plotted for the low and high Humanin/CRP ratio subgroups, and between-group comparisons were performed using the log-rank test. Results: A total of 154 hospitalized patients with acute exacerbation of CHF were enrolled, with a median age of 76 (68, 82) years and 64 (42%) males. The rehabilitation intervention group comprised 71 patients and the control group comprised 83 patients. The rehabilitation intervention group showed higher short physical performance battery scores (9 (8, 9) vs. 8 (7, 9), P=0.001) and 6-minute walk distance (309 (271, 344) m vs. 293 (222, 315) m, P=0.026) compared with the control group. The MACE incidence in the rehabilitation intervention group was 34% (24/71), representing an absolute risk reduction of 15% compared with 49% (41/83) in the control group; however, the difference was not statistically significant (P=0.051). Multivariate Cox regression analysis showed that Humanin/CRP ratio was negatively correlated with MACE risk (HR=0.999, 95%CI: 0.998-1.000, P=0.011). Receiver operating characteristic curve analysis indicated that the ratio predicted MACE with a sensitivity of 92.5% and a specificity of 27.5%. Kaplan-Meier survival curves demonstrated that the 6-month cumulative MACE-free survival rate was significantly lower in the low Humanin/CRP ratio subgroup than in the high ratio subgroup (log-rank P=0.008). Conclusions: Standardized rehabilitation therapy effectively improves physical performance and exercise tolerance in hospitalized patients with acute exacerbation of CHF, with a trend toward reduced MACE. Although the Humanin/CRP ratio was inversely associated with MACE risk, its discriminatory ability for risk stratification as a standalone indicator is limited, and it should be evaluated in conjunction with other clinical parameters.

Auteurs: C Y Li, N N Zhang, Y L Yang, S S Zhao, X F Xu, P Y Cao

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Bron: Zhonghua xin xue guan bing za zhi, https://doi.org/10.3760/cma.j.cn112148-20260515-00320. Bijgewerkt 2026-09-24T01:14:55Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.