Document Detail


Exercise training improves exercise capacity and quality of life in patients with inoperable or residual chronic thromboembolic pulmonary hypertension.
MedLine Citation:
PMID:  22848542     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aim of this prospective study was to evaluate the effects of exercise training in patients with inoperable or residual chronic thromboembolic pulmonary hypertension (CTEPH).
METHODS: Thirty-five consecutive patients with invasively confirmed inoperable or residual CTEPH (16 women;19 men; mean age 61±15 years, mean pulmonary artery pressure, 63±20 mmHg; primary inoperable n = 33, persisting pulmonary hypertension after pulmonary endarterectomy n = 2) on stable disease-targeted medication received exercise training in-hospital for 3 weeks and continued at home for 15 weeks. Medication remained unchanged during the study period. Efficacy parameters have been evaluated at baseline, after 3 and 15 weeks by blinded-observers. Survival rate has been evaluated in a follow-up period of median 36.4 months (interquartile range 26.6-46.6 months).
RESULTS: All patients tolerated exercise training without severe adverse events. Patients significantly improved the mean distance walked in 6 minutes compared to baseline by 61±54 meters after 3 weeks (p<0.001) and by 71±70 meters after 15 weeks (p = 0.001), as well as scores of quality-of-life questionnaire, peak oxygen consumption and maximal workload. NT-proBNP improved significantly after 3 weeks of exercise training (p = 0.046). The 1-year survival rate was 97%, 2-year survival rate was 94% and the 3-year-survival 86% respectively.
CONCLUSION: Training as add-on to medical therapy may be effective in patients with CTEPH to improve work capacity, quality of life and further prognostic relevant parameters and possibly improves the 1-, 2- and 3-year survival rate. Further multicentric randomized controlled studies are needed to confirm these promising results.
TRIAL REGISTRATION: ClinicalTrials.gov NCT01398345.
Authors:
Christian Nagel; Felix Prange; Stefan Guth; Jochen Herb; Nicola Ehlken; Christine Fischer; Frank Reichenberger; Stephan Rosenkranz; Hans-Juergen Seyfarth; Eckhard Mayer; Michael Halank; Ekkehard Grünig
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-07-25
Journal Detail:
Title:  PloS one     Volume:  7     ISSN:  1932-6203     ISO Abbreviation:  PLoS ONE     Publication Date:  2012  
Date Detail:
Created Date:  2012-07-31     Completed Date:  2013-04-09     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  101285081     Medline TA:  PLoS One     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e41603     Citation Subset:  IM    
Affiliation:
Centre for Pulmonary Hypertension, Thoraxclinic at University Hospital Heidelberg, Heidelberg, Germany.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01398345
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Chronic Disease
Exercise*
Exercise Therapy / adverse effects,  methods*
Female
Follow-Up Studies
Humans
Hypertension, Pulmonary / complications,  physiopathology*,  surgery,  therapy*
Male
Middle Aged
Pulmonary Embolism / complications*
Quality of Life*
Recurrence
Survival Analysis
Young Adult
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