Routine Rehabilitation as a Treatment Component for Patients With Pulmonary Arterial or Chronic Thromboembolic...

Area of Science:

• Cardiology
• Pulmonary Medicine
• Rehabilitation Medicine

Background:

• Historically, exercise was discouraged for pulmonary hypertension (PH) patients due to concerns about right-sided heart function.
• Current guidelines recognize the role of expert-center rehabilitation for pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH).
• This study investigates the real-world effects of routine rehabilitation in PH patients receiving multimodal treatment.

Purpose of the Study:

• To evaluate the safety and efficacy of supervised rehabilitation as an adjunct therapy for patients with pulmonary hypertension (PH).
• To assess the impact of rehabilitation on clinical outcomes, including functional capacity, hemodynamics, and risk stratification in PAH and CTEPH patients.

Main Methods:

• Patients with PAH or CTEPH were enrolled in either inpatient or outpatient rehabilitation programs alongside usual care.
• Assessments included New York Heart Association (NYHA) class, adverse events, 6-minute walk test (6MWT), hemodynamics, and risk stratification.
• Data were collected from March 2010 to May 2019, including 41 patients.

Main Results:

• No major adverse events or deaths related to right-sided heart failure progression were reported.
• Rehabilitation significantly improved NYHA class (mean difference -0.39) and 6MWT distance (mean difference 80 m).
• Right-sided heart hemodynamics improved, and risk assessment grade decreased by -0.25 points post-rehabilitation.

Conclusions:

• Supervised rehabilitation is a safe and effective component of multimodal treatment for patients with PAH and CTEPH.
• Rehabilitation leads to significant improvements in patient functional capacity and clinical outcomes.
• This approach supports enhanced right-sided heart hemodynamics and reduced risk stratification in PH patients.