For patients with heart failure (HF), comprehensive cardiac rehabilitation (CCR) is advocated but low adherence is often reported. In this study, the association of CCR completion and response with long-term clinical results was assessed and the observations underscore the importance of the post-CCR follow-up evaluation, including cardiopulmonary exercise testing, to determine a patient's adherence and response to the CCR program.

• In this study of 772 HF patients who took part in a 3 month CCR program, lower risks of subsequent HF hospitalization and death were observed in patients who completed the program.

• Within the group of patients who completed the program, the improvement in exercise capacity, but not in skeletal muscle strength, over the 3-month span was found to be related to better outcomes.