Pulmonary Rehabilitation in Patients With Pulmonary Hypertension

Mina Akizuki*, Naoki Serizawa, Yosuke Izoe, Osamu Ito and Masahiro Kohzuki

Pulmonary Rehabilitation in Patients With Pulmonary Hypertension.

In the past, physical activity was believed to carry a high risk of sudden cardiac death, increased
pulmonary remodeling resulting from high shear stress, or worsening of right heart failure in
patients with pulmonary hypertension (PH). PH is a hemodynamic and pathophysiologic condition defined as an increase in the mean pulmonary artery pressure (PAP) to ≥25 mmHg at rest, as assessed with right heart catheterization. The disease results in a markedly reduced exercise
capacity, which is mainly attributable to impaired cardiac output adaptation to the peripheral
oxygen requirements.

The results of the study indicated that respiratory and exercise training might add to the effectiveness of optimized medical therapy. Recently, Ehlken et al15 reported that exercise
training (including interval cycle ergometer training with low workload, walking exercise, dumbbell training of single muscle groups by using low weights [500-1000 g]) and respiratory training improved peak oxygen consumption and hemodynamics in patients with severe pulmonary arterial hypertension and inoperable CTEPH. This study reported that exercise training significantly improved cardiopulmonary parameters such as pulmonary vascular resistance and cardiac index at rest and during exercise, leading to an increase in exercise capacity. The effect of exercise training on cardiopulmonary function is of high interest; however, the precise mechanism through which exercise based interventions benefit patients with PH remains unclear. However, Fukui
et al. reported the efficacy of cardiac rehabilitation after BPA for CTEPH.

Pulm Res Respir Med Open J. 2017; SE(2): S1-S6. doi: 10.17140/PRRMOJ-SE-2-101