Supervised exercise training in patients with chronic thromboembolic pulmonary hypertension as early follow-up treatment after pulmonary endarterectomy: a prospective cohort study
Background: Data on exercise training in chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary endarterectomy (PEA) as well as data on clinical and haemodynamic changes shortly after PEA are lacking. Objective: The objective of this prospective study was to analyse the safety, feasib...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
[August 2020]
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| In: |
Respiration
Year: 2020, Volume: 99, Issue: 7, Pages: 577-588 |
| ISSN: | 1423-0356 |
| DOI: | 10.1159/000508754 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1159/000508754 Verlag, lizenzpflichtig, Volltext: https://www.karger.com/Article/FullText/508754 
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| Author Notes: | Christian Nagel, Mohammed Nasereddin, Nicola Benjamin, Benjamin Egenlauf, Satenik Harutyunova, Christina A. Eichstaedt, Panagiota Xanthouli, Eckhard Mayer, Ekkehard Grünig, Stefan Guth |
| Summary: | Background: Data on exercise training in chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary endarterectomy (PEA) as well as data on clinical and haemodynamic changes shortly after PEA are lacking. Objective: The objective of this prospective study was to analyse the safety, feasibility, and the effectiveness of combined supervised inpatient rehabilitation in patients with CTEPH directly after PEA. Methods: CTEPH patients started a 19-week rehabilitation program (3 weeks as inpatients and continued at home for another 16 weeks) with supervised exercise training as follow-up treatment shortly after PEA. Haemodynamics were assessed by right heart catheterisation before PEA and 22 weeks after PEA. Non-invasive assessments as transthoracic echocardiography and 6-min walking distance (6MWD) were performed before PEA and after 3 (that is, beginning of rehabilitation), 6, and 22 weeks following PEA. Adverse events were recorded throughout the study. Results: Forty-five CTEPH patients were included (49% female, 57.6 ± 12.4 years old, 60% WHO functional class III). Rehabilitation was started 3.3 ± 0.9 weeks after PEA. Exercise training was well tolerated in all patients without severe side effects. Haemodynamics measured by right heart catheterisation significantly improved from pre-PEA to 22 weeks post-PEA in cardiac output (+1.2 ± 1.5 L/min, 33.4%, = 0.001) and mean pulmonary arterial pressure (-19 ± 13 mm Hg, -39.6%, <i>p</i> < 0.0001). Right heart size measured by echocardiography, 6MWD, quality of life, and oxygen saturation significantly improved not only within the first 3 weeks after PEA but also during the following 19 weeks of exercise training. Conclusions: Supervised exercise training was feasible as early follow-up treatment after PEA. Further controlled studies are needed to discriminate the effects of PEA and early follow-up rehabilitation. Trial Registration: The study was registered at clinicaltrials.gov (NCT01393327) on July 13, 2011. The study start date was January 2010, and completion date was December 2013. |
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| Item Description: | Gesehen am 25.09.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1423-0356 |
| DOI: | 10.1159/000508754 |