AIMS: This prospective, randomized, controlled, multicentre study aimed to evaluate efficacy and safety of exercise training in patients with pulmonary arterial (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). METHODS AND RESULTS: For the first time a specialized PAH/CTEPH rehabilitation programme was implemented in 11 centres across 10 European countries. Out of 129 enrolled patients, 116 patients (58 vs. 58 randomized into a training or usual care control group) on disease-targeted medication completed the study [85 female; mean age 53.6 ± 12.5 years; mean pulmonary arterial pressure 46.6 ± 15.1 mmHg; World Health Organization (WHO) functional class II 53%, III 46%; PAH n = 98; CTEPH n = 18]. Patients of the training group performed a standardized in-hospital rehabilitation with mean duration of 25 days [95% confidence interval (CI) 17-33 days], which was continued at home. The primary endpoint, change of 6-min walking distance, significantly improved by 34.1 ± 8.3 m in the training compared with the control group (95% CI, 18-51 m; P < 0.0001). Exercise training was feasible, safe, and well-tolerated. Secondary endpoints showed improvements in quality of life (short-form health survey 36 mental health 7.3 ± 2.5, P = 0.004), WHO-functional class (training vs. control: improvement 9:1, worsening 4:3; χ2 P = 0.027) and peak oxygen consumption (0.9 ± 0.5 mL/min/kg, P = 0.048) compared with the control group. CONCLUSION: This is the first multicentre and so far the largest randomized, controlled study on feasibility, safety, and efficacy of exercise training as add-on to medical therapy in PAH and CTEPH. Within this study, a standardized specialized training programme with in-hospital start was successfully established in 10 European countries.
- Grünig, E.
- MacKenzie, A.
- Peacock, A. J.
- Eichstaedt, C. A.
- Benjamin, N.
- Nechwatal, R.
- Ulrich, S.
- Saxer, S.
- Bussotti, M.
- Sommaruga, M.
- Ghio, S.
- Gumbiene, L.
- Palevičiūtė, E.
- Jurevičienė, E.
- Cittadini, A.
- Stanziola, A. A.
- Marra, A. M.
- Kovacs, G.
- Olschewski, H.
- Barberà, J. A.
- Blanco, I.
- Spruit, M. A.
- Franssen, F. M. E.
- Vonk Noordegraaf, A.
- Reis, A.
- Santos, M.
- Viamonte, S. G.
- Demeyer, H.
- Delcroix, M.
- Bossone, E.
- Johnson, M.
Keywords
- Exercise programme
- Pulmonary hypertension
- Pulmonary rehabilitation