Thomas Koudstaal1, Monique Wapenaar, Dirk van Ranst, Ruud Beesems, Leon van den Toorn, Annemien van den Bosch, Prewesh Chandoesing, Karin Boomars. 1. Departments of Pulmonary Medicine (Drs Koudstaal, van den Toorn, Chandoesing, and Boomars and Ms Wapenaar) and Cardiology (Dr van den Bosch), Erasmus MC, University Medical Center Rotterdam, the Netherlands; and Pulmonary Rehabilitation Centre, Revant, Breda, the Netherlands (Dr van Ranst and Mr Beesems). Both T. Koudstaal and M. Wapenaar contributed equally and share first authorship for the article.
Abstract
PURPOSE: Pulmonary arterial hypertension (PAH) is characterized by right ventricular failure, leading to exertional dyspnea, skeletal muscle weakness, and poor quality of life (QOL). Apart from treatment with PAH-specific drugs, guidelines recommend pulmonary rehabilitation (PR). Clinical PR programs have shown improvement in functional capacity and QOL. However, little is known about the effectiveness of an outpatient PR program. The aim of our study was to assess effectiveness of a multidisciplinary outpatient PR program. METHODS: Patients with PAH or chronic thromboembolic pulmonary hypertension (CTEPH), who were in a stable condition on optimized drug therapy, followed a 10-wk outpatient program in a rehabilitation center. The PR program was designed to improve exercise capacity and health status by means of low load cycling, walking, and muscle training twice a week combined with psychological counseling. QOL was measured by the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) questionnaire. RESULTS: Twenty-one patients (13 women) with PAH (n = 16) or CTEPH (n = 5) completed the study. All patients were in New York Heart Association (NYHA) functional class III, and their mean age was 45 ± 16 yr. After PR, the mean cycling endurance time increased by 4.4 min (P < .001), 6-min walk distance by 12.2 m (P < .05), and maximum inspiratory pressure by 5.8 cm H2O (P = .01). Skeletal muscle function increased significantly. The CAMPHOR questionnaire demonstrated significant decrease in symptoms and improvement in QOL. Soluble biomarkers did not show any change before and after PR. CONCLUSIONS: Outpatient PR could be an effective instrument to improve exercise capacity and health status in patients with PAH or CTEPH.
PURPOSE:Pulmonary arterial hypertension (PAH) is characterized by right ventricular failure, leading to exertional dyspnea, skeletal muscle weakness, and poor quality of life (QOL). Apart from treatment with PAH-specific drugs, guidelines recommend pulmonary rehabilitation (PR). Clinical PR programs have shown improvement in functional capacity and QOL. However, little is known about the effectiveness of an outpatient PR program. The aim of our study was to assess effectiveness of a multidisciplinary outpatient PR program. METHODS:Patients with PAH or chronic thromboembolic pulmonary hypertension (CTEPH), who were in a stable condition on optimized drug therapy, followed a 10-wk outpatient program in a rehabilitation center. The PR program was designed to improve exercise capacity and health status by means of low load cycling, walking, and muscle training twice a week combined with psychological counseling. QOL was measured by the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) questionnaire. RESULTS: Twenty-one patients (13 women) with PAH (n = 16) or CTEPH (n = 5) completed the study. All patients were in New York Heart Association (NYHA) functional class III, and their mean age was 45 ± 16 yr. After PR, the mean cycling endurance time increased by 4.4 min (P < .001), 6-min walk distance by 12.2 m (P < .05), and maximum inspiratory pressure by 5.8 cm H2O (P = .01). Skeletal muscle function increased significantly. The CAMPHOR questionnaire demonstrated significant decrease in symptoms and improvement in QOL. Soluble biomarkers did not show any change before and after PR. CONCLUSIONS:Outpatient PR could be an effective instrument to improve exercise capacity and health status in patients with PAH or CTEPH.
Authors: Daniel Lachant; Christina Bach; Bennett Wilson; Vaseem Chengazi; Bruce Goldman; Neil Lachant; Anthony Pietropaoli; Scott Cameron; R James White Journal: Pulm Circ Date: 2020-09-21 Impact factor: 2.886
Authors: Karen S W Chia; Peter K K Wong; Senen Gonzalez; Eugene Kotlyar; Steven G Faux; Christine T Shiner Journal: Pulm Circ Date: 2020-05-14 Impact factor: 3.017