Exercise training improves peak oxygen consumption and haemodynamics in patients with severe pulmonary arterial hypertension and inoperable chronic thrombo-embolic pulmonary hypertension: A prospective, randomized, controlled trial

European Heart Journal

Volumn 37, Issue 1, 2016, Pages 35-44

  Ehlken, Nicola ^a   Lichtblau, Mona ^a   Klose, Hans ^b   Weidenhammer, Johannes ^a   Fischer, Christine ^a   Nechwatal, Robert ^c   Uiker, Sören ^c   Halank, Michael ^d   Olsson, Karen ^e   Seeger, Werner ^f   Gall, Henning ^f   Rosenkranz, Stephan ^g   Wilkens, Heinrike ^h   Mertens, Dirk ⁱ   Seyfarth, Hans Jürgen ^j   Opitz, Christian ^k   Ulrich, Silvia ^l   Egenlauf, Benjamin ^a   Grünig, Ekkehard ^a  

^a UNIVERSITY HOSPITAL HEIDELBERG   (Germany)

^b UNIVERSITY OF HAMBURG   (Germany)

^c Rehabilitation Clinic Heidelberg Koenigstuhl   (Germany)

^d DRESDEN UNIVERSITY OF TECHNOLOGY   (Germany)

^e HANNOVER MEDICAL SCHOOL   (Germany)

^f JUSTUS LIEBIG UNIVERSITY   (Germany)

^g Department of Cardiology ^*  (Germany)

^h SAARLAND UNIVERSITY   (Germany)

ⁱ JOHANNES GUTENBERG UNIVERSITY   (Germany)

^j UNIVERSITY OF LEIPZIG   (Germany)

^k DRK KLINIKEN BERLIN WESTEND   (Germany)

^l UNIVERSITY HOSPITAL ZURICH   (Switzerland)

more..

Author keywords

Cardiac index; Cardiac output; Cardiac rehabilitation; Pulmonary hypertension; Right heart catheterization

Indexed keywords

CALCIUM CHANNEL BLOCKING AGENT; ENDOTHELIN RECEPTOR ANTAGONIST; GUANYLATE CYCLASE ACTIVATOR; IMATINIB; PHOSPHODIESTERASE V INHIBITOR; PROSTANOID; BIOLOGICAL MARKER; BRAIN NATRIURETIC PEPTIDE; PEPTIDE FRAGMENT; PRO-BRAIN NATRIURETIC PEPTIDE (1-76);

ADULT; ARTICLE; BICYCLE ERGOMETER; CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION; CONTROLLED STUDY; DISEASE SEVERITY; EXERCISE; FEMALE; HEART CATHETERIZATION; HEART INDEX; HEART RATE; HEMODYNAMICS; HUMAN; LUNG ARTERY PRESSURE; LUNG VASCULAR RESISTANCE; MAJOR CLINICAL STUDY; MALE; OXYGEN CONSUMPTION; OXYGEN SATURATION; OXYGEN THERAPY; PRIORITY JOURNAL; PULMONARY HYPERTENSION; QUALITY OF LIFE; RANDOMIZED CONTROLLED TRIAL; WALKING; ANALYSIS OF VARIANCE; CHRONIC DISEASE; EXERCISE TEST; EXERCISE TOLERANCE; HEART OUTPUT; HEART RIGHT VENTRICLE FUNCTION; HYPERTENSION, PULMONARY; KINESIOTHERAPY; LUNG WEDGE PRESSURE; METABOLISM; MIDDLE AGED; PATHOPHYSIOLOGY; PHYSIOLOGY; PROCEDURES; PROSPECTIVE STUDY; THROMBOEMBOLISM; TREATMENT OUTCOME; VASCULAR RESISTANCE;

ANALYSIS OF VARIANCE; BIOMARKERS; CARDIAC OUTPUT; CHRONIC DISEASE; EXERCISE TEST; EXERCISE THERAPY; EXERCISE TOLERANCE; FEMALE; HEART RATE; HUMANS; HYPERTENSION, PULMONARY; MALE; MIDDLE AGED; NATRIURETIC PEPTIDE, BRAIN; OXYGEN CONSUMPTION; PEPTIDE FRAGMENTS; PROSPECTIVE STUDIES; PULMONARY WEDGE PRESSURE; THROMBOEMBOLISM; TREATMENT OUTCOME; VASCULAR RESISTANCE; VENTRICULAR DYSFUNCTION, RIGHT;

EID: 84960120156     PISSN: 0195668X     EISSN: 15229645     Source Type: Journal    
DOI: 10.1093/eurheartj/ehv337     Document Type: Article

References (38)

1. Mereles D, Ehlken N, Kreuscher S, Ghofrani S, Hoeper MM, Halank M, Meyer FJ, Karger G, Buss J, Juenger J, Holzapfel N, Opitz C, Winkler J, Herth FF, Wilkens H, Katus HA, Olschewski H, Grunig E. Exercise and respiratory training improve exercise capacity and quality of life in patients with severe chronic pulmonary hypertension. Circulation 2006;114:1482-1489.
2. de Man FS, Handoko ML, Groepenhoff H, van 't Hul AJ, Abbink J, Koppers RJ, Grotjohan HP, Twisk JW, Bogaard HJ, Boonstra A, Postmus PE, Westerhof N, van der Laarse WJ, Vonk-Noordegraaf A. Effects of exercise training in patients with idiopathic pulmonary arterial hypertension. Eur Respir J 2009;34:669-675.
3. Fox BD, Kassirer M, Weiss I, Raviv Y, Peled N, Shitrit D, Kramer MR. Ambulatory rehabilitation improves exercise capacity in patients with pulmonary hypertension. J Card Fail 2011;17:196-200.
4. Grünig E, Lichtblau M, Ehlken N, Ghofrani HA, Reichenberger F, Staehler G, Halank M, Fischer C, Seyfarth HJ, Klose H, Meyer A, Sorichter S, Wilkens H, Rosenkranz S, Opitz C, Leuchte H, Karger G, Speich R, Nagel C. Safety and efficacy of exercise training in various forms of pulmonary hypertension. Eur Respir J 2012; 40:84-92.
5. Chan L, Chin LM, Kennedy M, Woolstenhulme JG, Nathan SD, Weinstein AA, Connors G, Weir NA, Drinkard B, Lamberti J, Keyser RE. Benefits of intensive treadmill exercise training on cardiorespiratory function and quality of life in patients with pulmonary hypertension. Chest 2013;143:333-343.
6. Nagel C, Prange F, Guth S, Herb J, Ehlken N, Fischer C, Reichenberger F, Rosenkranz S, Seyfarth HJ, Mayer E, Halank M, Grünig E. Exercise training improves exercise capacity and quality of life in patients with inoperable or residual chronic thromboembolic pulmonary hypertension. PLoS ONE 2012;7:e41603.
7. Grunig E, Maier F, Ehlken N, Fischer C, Lichtblau M, Blank N, Fiehn C, Stockl F, Prange F, Staehler G, Reichenberger F, Tiede H, Halank M, Seyfarth HJ, Wagner S, Nagel C. Exercise training in pulmonary arterial hypertension associated with connective tissue diseases. Arthritis Res Ther 2012;14:R148.
8. Becker-Grunig T, Klose H, Ehlken N, Lichtblau M, Nagel C, Fischer C, Gorenflo M, Tiede H, Schranz D, Hager A, Kaemmerer H, Miera O, Ulrich S, Speich R, Uiker S, Grunig E. Efficacy of exercise training in pulmonary arterial hypertension associated with congenital heart disease. Int J Cardiol 2013;168:375-381.
9. Weinstein AA, Chin LM, Keyser RE, Kennedy M, Nathan SD, Woolstenhulme JG, Connors G, Chan L. Effect of aerobic exercise training on fatigue and physical activity in patients with pulmonary arterial hypertension. Respir Med 2013;107: 778-784.
10. Grünig E, Ehlken N, Ghofrani A, Staehler G, Meyer FJ, Juenger J, Opitz CF, Klose H, Wilkens H, Rosenkranz S, Olschewski H, Halank M. Effect of exercise and respiratory training on clinical progression and survival in patients with severe chronic pulmonary hypertension. Respiration 2011;81:394-401.
11. Galie N, Corris PA, Frost A, Girgis RE, Granton J, Jing ZC, Klepetko W, McGoon MD, McLaughlin VV, Preston IR, Rubin LJ, Sandoval J, Seeger W, Keogh A. Updated treatment algorithm of pulmonary arterial hypertension. J Am Coll Cardiol 2013;62(Suppl.):D60-D72.
12. Galie N, Simonneau G, Barst RJ, Badesch D, Rubin L. Clinical worsening in trials of pulmonary arterial hypertension: results and implications. Curr Opin Pulm Med 2010; 16(Suppl. 1):S11-S19.
13. Weissmann N, Peters DM, Klopping C, Kruger K, Pilat C, Katta S, Seimetz M, Ghofrani HA, Schermuly RT, Witzenrath M, Seeger W, Grimminger F, Mooren FC. Structural and functional prevention of hypoxia-induced pulmonary hypertension by individualized exercise training in mice. Am J Physiol Lung Cell Mol Physiol 2014;306:L986-L995.
14. Martinez-Quintana E, Miranda-Calderin G, Ugarte-Lopetegui A, Rodriguez-Gonzalez F. Rehabilitation program in adult congenital heart disease patients with pulmonary hypertension. Congenit Heart Dis 2010;5:44-50.
15. Boutet K, Garcia G, Degano B, Gonzalves-Tavares M, Tcherakian C, Jais X, Humbert M, Escourrou P, Simonneau G, Sitbon O. Results of a 12-week outpatient cardiovascular rehabilitation in patients with idiopathic pulmonary arterial hypertension (PAH). Eur Respir J 2008;32(Suppl 52):240s-41s.
16. Colombo R, Siqueira R, Becker CU, Fernandes TG, Pires KM, Valenca SS, Souza-Rabbo MP, Araujo AS, Bello-Klein A. Effects of exercise on monocrotaline-induced changes in right heart function and pulmonary artery remodeling in rats. Can J Physiol Pharmacol 2013;91:38-44.
17. Handoko ML, de Man FS, Happe CM, Schalij I, Musters RJ, Westerhof N, Postmus PE, Paulus WJ, van der Laarse WJ, Vonk-Noordegraaf A. Opposite effects of training in rats with stable and progressive pulmonary hypertension. Circulation 2009;120:42-49.
18. Chaouat A, Sitbon O, Mercy M, Poncot-Mongars R, Provencher S, Guillaumot A, Gomez E, Selton-Suty C, Malvestio P, Regent D, Paris C, Herve P, Chabot F. Prognostic value of exercise pulmonary haemodynamics in pulmonary arterial hypertension. Eur Respir J 2014;44:704-713.
19. Grunig E, Tiede H, Enyimayew EO, Ehlken N, Seyfarth HJ, Bossone E, D'Andrea A, Naeije R, Olschewski H, Ulrich S, Nagel C, Halank M, Fischer C. Assessment and prognostic relevance of right ventricular contractile reserve in patients with severe pulmonary hypertension. Circulation 2013;128:2005-2015.
20. Blumberg FC, Arzt M, Lange T, Schroll S, Pfeifer M, Wensel R. Impact of right ventricular reserve on exercise capacity and survival in patients with pulmonary hypertension. Eur J Heart Fail 2013;15:771-775.
21. Bossone E, D'Andrea A, D'Alto M, Citro R, Argiento P, Ferrara F, Cittadini A, Rubenfire M, Naeije R. Echocardiography in pulmonary arterial hypertension: from diagnosis to prognosis. J Am Soc Echocardiogr 2013;26:1-14.
22. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982;14: 377-381.
23. Erbs S, Linke A, Gielen S, Fiehn E, Walther C, Yu J, Adams V, Schuler G, Hambrecht R. Exercise training in patients with severe chronic heart failure: impact on left ventricular performance and cardiac size. A retrospective analysis of the Leipzig Heart Failure Training Trial. Eur J Cardiovasc Prev Rehabil 2003;10:336-344.
24. Lewis GD, Bossone E, Naeije R, Grunig E, Saggar R, Lancellotti P, Ghio S, Varga J, Rajagopalan S, Oudiz R, Rubenfire M. Pulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases. Circulation 2013;128:1470-1479.
25. Argiento P, Vanderpool RR, Mule M, Russo MG, D'Alto M, Bossone E, Chesler NC, Naeije R. Exercise stress echocardiography of the pulmonary circulation: limits of normal and sex differences. Chest 2012;142:1158-1165.
26. Gorcsan J III, Murali S, Counihan PJ, Mandarino WA, Kormos RL. Right ventricular performance and contractile reserve in patients with severe heart failure. Assessment by pressure-area relations and association with outcome. Circulation 1996; 94:3190-3197.
27. McLaughlin VV, Presberg KW, Doyle RL, Abman SH, McCrory DC, Fortin T, Ahearn G. Prognosis of pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines. Chest 2004;126(Suppl.):78s-92s.
28. Andersen P. Capillary density in skeletal muscle of man. Acta Physiol Scand 1975;95: 203-205.
29. Brodal P, Ingjer F, Hermansen L. Capillary supply of skeletal muscle fibers in untrained and endurance-trained men. Am J Physiol 1977;232:H705-H712.
30. Hudlicka O, Brown M, Egginton S. Angiogenesis in skeletal and cardiac muscle. Physiol Rev 1992;72:369-417.
31. Coats AJ, Adamopoulos S, Radaelli A, McCance A, Meyer TE, Bernardi L, Solda PL, Davey P, Ormerod O, Forfar C, Conway J, Sleight P. Controlled trial of physical training in chronic heart failure. Exercise performance, hemodynamics, ventilation, and autonomic function. Circulation 1992;85:2119-2131.
32. Drexler H, Riede U, Munzel T, Konig H, Funke E, Just H. Alterations of skeletal muscle in chronic heart failure. Circulation 1992;85:1751-1759.
33. Hambrecht R, Fiehn E, Weigl C, Gielen S, Hamann C, Kaiser R, Yu J, Adams V, Niebauer J, Schuler G. Regular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with chronic heart failure. Circulation 1998;98:2709-2715.
34. Gielen S, Adams V, Mobius-Winkler S, Linke A, Erbs S, Yu J, KempfW, Schubert A, Schuler G, Hambrecht R. Anti-inflammatory effects of exercise training in the skeletal muscle of patients with chronic heart failure. J Am Coll Cardiol 2003;42: 861-868.
35. Conraads VM, Beckers P, Bosmans J, De Clerck LS, Stevens WJ, Vrints CJ, Brutsaert DL. Combined endurance/resistance training reduces plasma TNF-alpha receptor levels in patients with chronic heart failure and coronary artery disease. Eur Heart J 2002;23:1854-1860.
36. Petersen AM, Pedersen BK. The anti-inflammatory effect of exercise. J Appl Physiol 2005;98:1154-1162.
37. Erbs S, Hollriegel R, Linke A, Beck EB, Adams V, Gielen S, Mobius-Winkler S, Sandri M, Krankel N, Hambrecht R, Schuler G. Exercise training in patients with advanced chronic heart failure (NYHA IIIb) promotes restoration of peripheral vasomotor function, induction of endogenous regeneration, and improvement of left ventricular function. Circ Heart Fail 2010;3:486-494.
38. Wisloff U, Stoylen A, Loennechen JP, Bruvold M, Rognmo O, Haram PM, Tjonna AE, Helgerud J, Slordahl SA, Lee SJ, Videm V, Bye A, Smith GL, Najjar SM, Ellingsen O, Skjaerpe T. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: A randomized study. Circulation 2007; 115:3086-3094.