Clinical Research Directory

INCLUSION CRITERIA * Age ≥18 years. * Referred to and eligible for participation in a CR programme according to standard clinical practice. * Diagnosis of cardiovascular disease, including but not limited to coronary artery disease, chronic heart failure, or other indications for CR. * Ability to perform CPET safely, as determined by the treating physician. * Baseline CPET allowing identification of both the first ventilatory threshold (VT1) and the second ventilatory threshold (VT2), with corresponding heart rate values available for exercise prescription. * Ability to understand the study procedures and provide written informed consent. VT1 and VT2 will be identified locally by the clinical team performing the CPET, according to routine practice at each participating centre. Participants in whom either threshold cannot be identified will not proceed to randomisation. EXCLUSION CRITERIA * Contraindications to exercise testing or training according to established clinical guidelines. * Foreseeable prolonged interruptions or planned interventions during the 15-week intervention period that, in the investigator's judgement, are expected to substantially limit participation in the supervised exercise programme. * Cardiac rhythm or device-related conditions that prevent reliable heart rate-based exercise prescription during exercise (e.g. non-sinus rhythm such as atrial fibrillation, pacemaker-dependent heart-rate response). * Heart-rate reserve (HRR) \<35 bpm on baseline CPET, considered insufficient for practical implementation of heart rate-based exercise prescription. * Any medical, physical, or cognitive condition that, in the opinion of the investigator, would preclude safe participation in the study or adherence to the rehabilitation programme. * Participation in another interventional study that may interfere with the outcomes of this trial. The HRR criterion is a study-specific operational criterion intended to ensure a sufficient overall heart-rate range for practical implementation of heart rate-based exercise prescription. In the range-based comparator arm, an HRR of ≥35 bpm corresponds to a prescribed heart-rate interval of approximately 10 bpm or more between 40% and 69% HRR. These criteria are designed to reflect routine clinical practice while ensuring safe and appropriate application of the exercise prescription strategies under investigation.