INTRODUCTION: A majority of patients with idiopathic pulmonary arterial hypertension (IPAH) display persistent exercise intolerance despite current therapies. Whether a rehabilitation program elicits favorable changes in muscle function which would partly explain improvements in exercise tolerance of IPAH patients remains unknown. We performed this study to assess the effect of a 12-week rehabilitation program on skeletal muscle characteristics and exercise tolerance in patients with IPAH. METHODS: Exercise capacity measured by the 6-minute walk test and by the cycle endurance test (CET), limb muscle cross-sectional area, quadriceps function by maximal voluntary contraction and magnetic stimulation (potentiated twitches), and molecular muscle characteristics by quadriceps biopsy of 5 IPAH patients were assessed before and after a 12-week rehabilitation program. RESULTS: Following training, improvements in all patients were observed for the 6-minute walk test distance, from 441 (75) to 499 (85) m, P = .01, and the CET time, from 429 (239) to 633 (380) seconds, P = .16. Minute ventilation assessed at isotime during CET decreased by 15(11)%, P = .05. This was related to both decreased carbon dioxide output and (Equation is included in full-text article.)E/(Equation is included in full-text article.)co2. These improvements were associated with decreased type IIx fiber proportion, 31(8)% to 23(10)%, P = .05. DISCUSSION: Peripheral muscle characteristic improvements may contribute to the clinical benefit observed following a rehabilitation program in IPAH.
INTRODUCTION: A majority of patients with idiopathic pulmonary arterial hypertension (IPAH) display persistent exercise intolerance despite current therapies. Whether a rehabilitation program elicits favorable changes in muscle function which would partly explain improvements in exercise tolerance of IPAH patients remains unknown. We performed this study to assess the effect of a 12-week rehabilitation program on skeletal muscle characteristics and exercise tolerance in patients with IPAH. METHODS: Exercise capacity measured by the 6-minute walk test and by the cycle endurance test (CET), limb muscle cross-sectional area, quadriceps function by maximal voluntary contraction and magnetic stimulation (potentiated twitches), and molecular muscle characteristics by quadriceps biopsy of 5 IPAH patients were assessed before and after a 12-week rehabilitation program. RESULTS: Following training, improvements in all patients were observed for the 6-minute walk test distance, from 441 (75) to 499 (85) m, P = .01, and the CET time, from 429 (239) to 633 (380) seconds, P = .16. Minute ventilation assessed at isotime during CET decreased by 15(11)%, P = .05. This was related to both decreased carbon dioxide output and (Equation is included in full-text article.)E/(Equation is included in full-text article.)co2. These improvements were associated with decreased type IIx fiber proportion, 31(8)% to 23(10)%, P = .05. DISCUSSION: Peripheral muscle characteristic improvements may contribute to the clinical benefit observed following a rehabilitation program in IPAH.
Authors: Joshua G Woolstenhulme; Andrew A Guccione; Jeffrey E Herrick; John P Collins; Steven D Nathan; Leighton Chan; Randall E Keyser Journal: J Cardiopulm Rehabil Prev Date: 2019-03 Impact factor: 2.081
Authors: Mary Beth Brown; Evandro Neves; Gary Long; Jeremy Graber; Brett Gladish; Andrew Wiseman; Matthew Owens; Amanda J Fisher; Robert G Presson; Irina Petrache; Jeffrey Kline; Tim Lahm Journal: Am J Physiol Regul Integr Comp Physiol Date: 2016-10-26 Impact factor: 3.619
Authors: Leighton Chan; Lisa M K Chin; Michelle Kennedy; Joshua G Woolstenhulme; Steven D Nathan; Ali A Weinstein; Gerilynn Connors; Nargues A Weir; Bart Drinkard; James Lamberti; Randall E Keyser Journal: Chest Date: 2013-02-01 Impact factor: 9.410