Cargando…

Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension

OBJECTIVE: To determine safety and efficacy of cardiac rehabilitation (CR) initiated immediately following balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) who presented with continuing exercise intolerance and symptoms on effort e...

Descripción completa

Detalles Bibliográficos
Autores principales: Fukui, Shigefumi, Ogo, Takeshi, Takaki, Hiroshi, Ueda, Jin, Tsuji, Akihiro, Morita, Yoshiaki, Kumasaka, Reon, Arakawa, Tetsuo, Nakanishi, Michio, Fukuda, Tetsuya, Yasuda, Satoshi, Ogawa, Hisao, Nakanishi, Norifumi, Goto, Yoichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013094/
https://www.ncbi.nlm.nih.gov/pubmed/27220694
http://dx.doi.org/10.1136/heartjnl-2015-309230
_version_ 1782452101991890944
author Fukui, Shigefumi
Ogo, Takeshi
Takaki, Hiroshi
Ueda, Jin
Tsuji, Akihiro
Morita, Yoshiaki
Kumasaka, Reon
Arakawa, Tetsuo
Nakanishi, Michio
Fukuda, Tetsuya
Yasuda, Satoshi
Ogawa, Hisao
Nakanishi, Norifumi
Goto, Yoichi
author_facet Fukui, Shigefumi
Ogo, Takeshi
Takaki, Hiroshi
Ueda, Jin
Tsuji, Akihiro
Morita, Yoshiaki
Kumasaka, Reon
Arakawa, Tetsuo
Nakanishi, Michio
Fukuda, Tetsuya
Yasuda, Satoshi
Ogawa, Hisao
Nakanishi, Norifumi
Goto, Yoichi
author_sort Fukui, Shigefumi
collection PubMed
description OBJECTIVE: To determine safety and efficacy of cardiac rehabilitation (CR) initiated immediately following balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) who presented with continuing exercise intolerance and symptoms on effort even after a course of BPA; 2–8 sessions/patient. METHODS: Forty-one consecutive patients with inoperable CTEPH who underwent their final BPA with improved resting mean pulmonary arterial pressure of 24.7±5.5 mm Hg and who suffered remaining exercise intolerance were prospectively studied. Participants were divided into two groups just after the final BPA (6.8±2.3 days): patients with (CR group, n=17) or without (non-CR group, n=24) participation in a 12-week CR of 1-week inhospital training followed by an 11-week outpatient programme. Cardiopulmonary exercise testing, haemodynamics, and quality of life (QOL) were assessed before and after CR. RESULTS: No significant between-group differences were found for any baseline characteristics. At week 12, peak oxygen uptake (VO(2)), per cent predicted peak VO(2) (70.7±9.4% to 78.2±12.8%, p<0.01), peak workload, and oxygen pulse significantly improved in the CR group compared with the non-CR group, with a tendency towards improvement in mental health-related QOL. Quadriceps strength and heart failure (HF) symptoms (WHO functional class, 2.2–1.8, p=0.01) significantly improved within the CR group. During the CR, no patient experienced adverse events or deterioration of right-sided HF or haemodynamics as confirmed via catheterisation. CONCLUSIONS: The combination of BPA and subsequent CR is a new treatment strategy for inoperable CTEPH to improve exercise capacity to near-normal levels and HF symptoms, with a good safety profile.
format Online
Article
Text
id pubmed-5013094
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-50130942016-09-12 Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension Fukui, Shigefumi Ogo, Takeshi Takaki, Hiroshi Ueda, Jin Tsuji, Akihiro Morita, Yoshiaki Kumasaka, Reon Arakawa, Tetsuo Nakanishi, Michio Fukuda, Tetsuya Yasuda, Satoshi Ogawa, Hisao Nakanishi, Norifumi Goto, Yoichi Heart Pulmonary Vascular Disease OBJECTIVE: To determine safety and efficacy of cardiac rehabilitation (CR) initiated immediately following balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) who presented with continuing exercise intolerance and symptoms on effort even after a course of BPA; 2–8 sessions/patient. METHODS: Forty-one consecutive patients with inoperable CTEPH who underwent their final BPA with improved resting mean pulmonary arterial pressure of 24.7±5.5 mm Hg and who suffered remaining exercise intolerance were prospectively studied. Participants were divided into two groups just after the final BPA (6.8±2.3 days): patients with (CR group, n=17) or without (non-CR group, n=24) participation in a 12-week CR of 1-week inhospital training followed by an 11-week outpatient programme. Cardiopulmonary exercise testing, haemodynamics, and quality of life (QOL) were assessed before and after CR. RESULTS: No significant between-group differences were found for any baseline characteristics. At week 12, peak oxygen uptake (VO(2)), per cent predicted peak VO(2) (70.7±9.4% to 78.2±12.8%, p<0.01), peak workload, and oxygen pulse significantly improved in the CR group compared with the non-CR group, with a tendency towards improvement in mental health-related QOL. Quadriceps strength and heart failure (HF) symptoms (WHO functional class, 2.2–1.8, p=0.01) significantly improved within the CR group. During the CR, no patient experienced adverse events or deterioration of right-sided HF or haemodynamics as confirmed via catheterisation. CONCLUSIONS: The combination of BPA and subsequent CR is a new treatment strategy for inoperable CTEPH to improve exercise capacity to near-normal levels and HF symptoms, with a good safety profile. BMJ Publishing Group 2016-09-01 2016-05-24 /pmc/articles/PMC5013094/ /pubmed/27220694 http://dx.doi.org/10.1136/heartjnl-2015-309230 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Pulmonary Vascular Disease
Fukui, Shigefumi
Ogo, Takeshi
Takaki, Hiroshi
Ueda, Jin
Tsuji, Akihiro
Morita, Yoshiaki
Kumasaka, Reon
Arakawa, Tetsuo
Nakanishi, Michio
Fukuda, Tetsuya
Yasuda, Satoshi
Ogawa, Hisao
Nakanishi, Norifumi
Goto, Yoichi
Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension
title Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension
title_full Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension
title_fullStr Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension
title_full_unstemmed Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension
title_short Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension
title_sort efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension
topic Pulmonary Vascular Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013094/
https://www.ncbi.nlm.nih.gov/pubmed/27220694
http://dx.doi.org/10.1136/heartjnl-2015-309230
work_keys_str_mv AT fukuishigefumi efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT ogotakeshi efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT takakihiroshi efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT uedajin efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT tsujiakihiro efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT moritayoshiaki efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT kumasakareon efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT arakawatetsuo efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT nakanishimichio efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT fukudatetsuya efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT yasudasatoshi efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT ogawahisao efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT nakanishinorifumi efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension
AT gotoyoichi efficacyofcardiacrehabilitationafterballoonpulmonaryangioplastyforchronicthromboembolicpulmonaryhypertension