Integrating omics to optimize precision cardiac rehabilitation

Cardiovascular diseases (CVD) remain the leading global cause of mortality with a complex etiology involving both genetic and environmental factors. Despite the identification of numerous genetic loci associated with CVD, the mechanisms underlying disease variability are incompletely understood. Recent advances in multi-omics technologies, including genomics, epigenomics, transcriptomics, proteomics, metabolomics, and microbiomics, offer a more comprehensive view of the molecular networks involved in disease progression and recovery. This commentary explores how multi-omics data could enhance cardiac rehabilitation (CR) by identifying novel biomarkers, revealing individualized responses to exercise, and informing personalized therapeutic strategies. We present specific use cases for omics technology in CR, highlight barriers such as cost and implementation feasibility, and propose future research directions, including the need for pilot studies and standardization protocols. Integrating omics technologies into CR has the potential to improve patient outcomes and promote precision cardiovascular care, provided that practical and ethical challenges are adequately addressed.