Pulmonary rehabilitation(PR) is recommended for patients with pulmonary hypertension (PH) but little is known about its efficacy and safety. We evaluated the outcomes of our PR patients with pulmonary arterial hypertension(PAH)and pulmonary hypertension associated with lung disease(PHLD).
Patients enrolled in our single center PR program diagnosed with these conditions were reviewed. Demographics, outcomes and Chronic Respiratory Disease Questionaire(CRDQ)data were analyzed and compared.
8 patients with PAH(2 IPAH, 4 CTEPH, 1 PSS, 1 Drug induced) and 12 with PHLD(7 COPD, 2 IPF, 1 Sarcoidosis, 2 OSA)were identified. The PAH group was all female and slightly younger(63±13) than the PHLD(68±12)group(8F, 4M). The number of exercise sessions(24±13 vs 25±8), days to complete therapy(72±14 vs 65±17), pre-6MW distance(260m±79 vs 264m±100), supplemental O2(3L±2.14 vs 2.8±1.9), and WHO Symptom Class(3.5±0.76 vs 3.4±0.55) were similar. 4/8 PAH patients completed PR; 2 expired while enrolled, 1 developed knee pain, 1 had symptomatic PVCs during exercise. 8/12 PHLD patients completed PR; 1 expired, 1 received a lung transplant, 2 were lost to follow up. 6 MW distance improved post PR in the combined group of PH patients from 268m±105 to 351±47(p=0.006). CDRQ data revealed improvement in Dyspnea(17.6±2.7 to 22.1±4), Fatigue(14.6±5 to 19.2±4), and Mastery(21±2.3 to 24±3).
Pulmonary rehabilitation improves 6MW distance and CRDQ Score(Dyspnea, Fatigue, Mastery Domains)in Class III-IV pulmonary hypertension patients. The high severity of illness in the PAH group lead to low program completion. Earlier referral to PR may be beneficial.
Pulmonary rehabilitation improves physical conditioning and overall “well being”. It is an effective and safe treatment for patients with PH.
HemodynamicsPAHPHLDEcho PASP(mmHg)79±1960±17p=0.04RV diameter(cm)3.06±0.72.11±0.5p=0.009mPAP(mmHg)52±1632±4p=0.04PVR(WU)12.7±7
Maria Carrillo, None.