Efficacy of exercise training in pulmonary arterial hypertension associated with congenital heart disease
Tabea Becker-Grünig, Hans Klose, Nicola Ehlken, Mona Lichtblau, Christian Nagel, Christine Fischer, Matthias Gorenflo, Henning Tiede, Dietmar Schranz, Alfred Hager, Harald Kaemmerer, Oliver Miera, Silvia Ulrich, Rudolf Speich, Sören Uiker, Ekkehard Grünig, Tabea Becker-Grünig, Hans Klose, Nicola Ehlken, Mona Lichtblau, Christian Nagel, Christine Fischer, Matthias Gorenflo, Henning Tiede, Dietmar Schranz, Alfred Hager, Harald Kaemmerer, Oliver Miera, Silvia Ulrich, Rudolf Speich, Sören Uiker, Ekkehard Grünig
Abstract
Background: The objective of this prospective study was to assess the efficacy of exercise training as add-on to medical therapy in patients with congenital heart disease associated pulmonary arterial hypertension (CHD-APAH).
Methods: Patients with invasively confirmed CHD-APAH received in-hospital exercise training for 3 weeks and continued at home. Efficacy parameters were evaluated at baseline, after 3 and 15 weeks. Medical treatment remained unchanged. Worsening events and survival rate were assessed in a follow-up period of 21 ± 14 months.
Results: Twenty consecutive CHD-APAH patients (16 female, 4 male, mean pulmonary arterial pressure 60 ± 23 mm Hg) were included. Patients significantly improved the mean distance walked in 6 min compared to baseline by 63 ± 47 m after 3 weeks (p<0.001) and by 67 ± 59 m after 15 weeks (p=0.001). Quality of life-score (p=0.05), peak oxygen consumption (p=0.002) and maximal workload (p=0.003) improved significantly by exercise training after 15 weeks. The 1- and 2-year survival rates were 100%, the transplantation-free survival rate was 100% after 1 year and 93% after 2 years.
Conclusion: Exercise training as add-on to medical therapy may be effective in patients with CHD-APAH and improved work capacity, quality of life and further prognostic relevant parameters. It was associated with an excellent long-term survival. Further randomized controlled studies are needed to confirm these results.
Keywords: Congenital heart disease; Exercise training; Pulmonary hypertension; Rehabilitation.
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Source: PubMed