The Most Recent European and American Guidelines on Cardiac Rehabilitation: A Lack of Focus on Diaphragm Training.
Cardiovascular diseases (CVDs) are the leading causes of death and morbidity worldwide. Patients with vascular and cardiac conditions undergo cardiac rehabilitation (CR), a process that may begin before surgery (less frequently), after invasive procedures, or as part of chronic disease management, with durations varying by healthcare facilities or national policies. CR is a valuable non-pharmacological intervention that supports patient health and the resumption of daily activities. These rehabilitation programmes are strongly recommended for cardiac patients and are structured according to guidelines from organisations such as the European Society of Cardiology (ESC) and the American Heart Association/American Association of Cardiovascular and Pulmonary Rehabilitation (AHA/AACPR). This editorial reviews the latest ESC and AHA/AACPR guidelines, emphasising physical activities such as endurance and resistance training, while highlighting the lack of detail on inspiratory muscle training (IMT). The editorial reiterates the Italian Association of Cardiovascular Rehabilitation (AIRC) proposals regarding IMT and calls for further clinical trials.