Abstract
Small studies have shown that exercise training can result in improvements in endothelial function, myocardial perfusion, exercise capacity, and overall wellbeing and quality of life in patients with INOCA. Structured cardiac rehabilitation programs have also been shown to improve symptoms of angina, physical functioning, and quality of life for patients with INOCA. Studies of cardiac rehabilitation among patients with MINOCA have found that only one third participate in cardiac rehabilitation, but among those who do, observational studies and a randomized controlled trial demonstrate a lower risk of major adverse cardiovascular events (such as all-cause mortality and nonfatal myocardial infarction) with cardiac rehabilitation. However, given that INOCA and MINOCA are conditions that predominantly affect women and may be caused by non-atherosclerotic mechanisms, tailoring of traditional cardiac rehabilitation programs (eg, education components) may be desirable to meet the specific needs of these patients. Future studies should explore the effectiveness of tailored cardiac rehabilitation programs with novel delivery methods to optimize programs for patients with INOCA and MINOCA.