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Frailty in Pulmonary Hypertension: A Multidimensional Comorbidity
Meenakshi Sridhar1, Anoosha Tauquir2, Sandeep Sahay3
1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Annals of the American Thoracic Society
|April 16, 2025
Summary
Pulmonary arterial hypertension (PAH) and frailty share molecular pathways like inflammation and oxidative stress. Exercise may improve frailty in PAH, but more research is needed for assessment and treatment.
Area of Science:
- Cardiology
- Pulmonology
- Geriatrics
Background:
- Pulmonary hypertension (PH) is a severe condition with 5 etiological groups.
- Frailty is a complex disorder causing physical, cognitive, and psychological decline.
- Frailty's role in pulmonary arterial hypertension (PAH) is understudied despite links to heart and lung diseases.
Purpose of the Study:
- To review the pathobiology of frailty in PH.
- To discuss assessment tools for frailty in PH.
- To explore potential interventions for frailty in PAH.
Main Methods:
- Narrative review of existing literature.
- Analysis of molecular pathways involved in PH and frailty.
- Examination of exercise interventions in related conditions.
Main Results:
- Inflammation, oxidative stress, senescence, and mitochondrial dysfunction are key molecular links.
- Muscle dysfunction leads to exercise intolerance and deconditioning, exacerbating frailty.
- Exercise training shows potential for improving quality of life and frailty in PAH.
Conclusions:
- Frailty significantly impacts PH patients, particularly in PAH.
- Further studies are required to validate frailty's predictive value and develop targeted interventions.
- Individualized care plans incorporating frailty assessment are crucial for improving PAH outcomes.
