Exercise tolerance improves after pulmonary rehabilitation in pulmonary hypertension patients

Abstract

Pulmonary rehabilitation (PR) is part of the recommended management plan of pulmonary hypertension (PHTN) and is important to better quali-ty of life and exercise tolerance. This study aimed at determining effec-tiveness of PR on exercise capacity. Retrospective chart analysis was conducted on patients referred to our PHTN clinic for PR. Patients who had PHTN diagnosed on right heart catheterization (defined by mean pulmonary artery pressure > 25 mmHg) and completed a standardized 12-week PR program were considered for the study. Patients' baseline exercise tolerance was recorded as speed attainable on a treadmill and duration of exercise in minutes. Demographics, age, sex, and oxy-gen use were obtained from chart review. Eighteen PHTN patients (5 male, 13 female; mean age 67.7±11.6 years) were considered for the study (six World Health Organization [WHO] group 1 pulmonary arterial hypertension [33.33%], eight WHO group III PHTH [44.44%], two WHO group IV and two WHO V PHTN [11.11%]). Treadmill speed improved following rehabilitation (1.3 mph [interquartile range (IQR), 1.0-1.8 mph] to 2.2 mph [IQR, 1.3-2.8 mph]; P < 0.0001, Wilcoxon signed rank test). Median exercise time improved (27 min (IQR, 22-30 min) to 30 min (IQR, 24-30 min); not significant. Improvement was defined only as an in-crease in speed or duration, or both. Sixteem of 18 participants im-proved (88.9% [95% exact binomial confidence interval, 65.3%-98.6%). Patients with PHTN benefit from a structured PR program to improve their exercise capacity and should be enrolled in PR programs as part of their management.