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Master Thesis

Rehabilitation in pulmonary arterial hypertension: the REHAB-HTP study

Abstract : BACKGROUND: Pulmonary arterial hypertension (PAH) is a life-threatening condition. Current ESC guidelines recommend exercise training and rehabilitation in clinically stable PAH patients.
PURPOSE: To assess the beneficial effect of exercise training on exercise capacity, quality of life and cardiac function as assessed by echocardiography and cardio-pulmonary exercise test.
METHODS: We prospectively included 12 clinically stable PAH patients over a 6-months period. Exercise stress echocardiography (ESE), cardio-pulmonary exercise test (CPET), SF-12 quality of life questionnaire, 6-minute walk distance (6MWD), BNP and clinical assessment were performed before and after cardio-pulmonary rehabilitation. Patients underwent 8-weeks of exercise training (3 times a week of aerobic training and at home daily prescribed exercises).
RESULTS: All patients underwent ESE and CPET without any complication. Seven patients experienced a reduction in WHO functional class whereas 5 remained stable. Patients significantly improved their physical quality of life (p=0.006). They also improved their exercise capacity according to the maximum workload during CPET (p=0.006), CPET duration (p=0.002) and 6MWD distance (+32.58m, p=0.02). Anaerobic threshold and peak VO2 (+1.60mL/kg/min) improved significantly (p=0.03 and 0.005). Regarding imaging data, at rest, peak strain improved after rehabilitation (p=0.03) whereas the RV became more dilated. RV contractile reserve, defined by the change in peak systolic longitudinal RV strain between rest and maximum exercise, significantly improved (-8.08±4.8%, p=0.02).
CONCLUSION: In this preliminary study, cardio-pulmonary rehabilitation led to improved quality of life and exercise capacity in PAH. The increased RV contractile reserve post-rehabilitation might explain, in association with the peripheral muscular effects of exercise training, the clinical benefits of rehabilitation in PAH.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02390015
Contributor : Bibliothèque Universitaire de Médecine Nice <>
Submitted on : Monday, December 2, 2019 - 6:01:35 PM
Last modification on : Monday, October 12, 2020 - 10:28:06 AM
Long-term archiving on: : Tuesday, March 3, 2020 - 9:45:57 PM

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2019NICEM073.pdf
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  • HAL Id : dumas-02390015, version 1

Citation

Aude Missana. Rehabilitation in pulmonary arterial hypertension: the REHAB-HTP study. Human health and pathology. 2019. ⟨dumas-02390015⟩

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