Pulmonary hypertension and exercise training: a synopsis on the more recent evidences

Ann Med. 2018 May;50(3):226-233. doi: 10.1080/07853890.2018.1432887. Epub 2018 Jan 30.

Abstract

The benefits of exercise training in virtually all humans, including those with a clinically stable chronic disease are numerous. The potential value lies in the fact that functional capacity is oftentimes significantly compromised. Exercise training not only play a role in reversing some of the pathophysiologic processes associated with chronic diseases but also improves clinical trajectory. Given the significant pathologic consequences associated with pulmonary hypertension and its implications for deteriorating right ventricular function as well as the perceived potential for a precipitous and possibly critical drop in cardiac output during periods of physical exertion, exercise training was historically not recommended for these patients. More recently, a promising body of literature demonstrating the safety and efficacy of exercise training (with benefit on exercise capacity, peak oxygen consumption and quality of life) in pulmonary hypertension patients has emerged, but the conclusion about the effects of exercise training were non-exhaustive and therefore there is still a lack of knowledge regarding exercise training for these patients. Thus, we aim to ascertain the current effectiveness of exercise rehabilitation for pulmonary hypertension by performing a brief overview on the latest currently available evidences in such an "at a glance" synopsis addressed to summarize/quantify the more recent existing body of literature. KEY MESSAGES Exercise training was historically not recommended in pulmonary hypertension. Recently, exercise training safety-efficacy in pulmonary hypertension has emerged. Exercise training should be recommended in addition to optimal medical therapy.

Keywords: Pulmonary hypertension; exercise training; rehabilitation.

Publication types

  • Review

MeSH terms

  • Evidence-Based Medicine / methods*
  • Evidence-Based Medicine / standards
  • Evidence-Based Medicine / trends
  • Exercise Therapy / methods*
  • Exercise Therapy / standards
  • Exercise Therapy / trends
  • Humans
  • Hypertension, Pulmonary / rehabilitation*
  • Physical Conditioning, Human / methods*
  • Physical Conditioning, Human / standards
  • Physical Conditioning, Human / trends
  • Practice Guidelines as Topic
  • Quality of Life
  • Treatment Outcome