[Feasibility of cardiopulmonary rehabilitation in patients with idiopathic pulmonary arterial hypertension treated with intravenous prostacyclin infusion therapy].

Abstract

OBJECTIVES:

To evaluate cardiopulmonary rehabilitation in patients with idiopathic pulmonary arterial hypertension who had severe heart failure.

METHODS:

The subjects comprised 11 men and 13 women aged 5 to 37 years old with idiopathic pulmonary arterial hypertension, who received cardiopulmonary rehabilitation following the start of continuous intravenous prostacyclin administration between January 1999 and September 2003. Fifteen patients were categorized in New York Heart Association (NYHA) functional class-III and 9 were class-IV on admission. Patients received cardiopulmonary rehabilitation consisting of breathing exercise, training of upper extremity muscles, gait training, bicycle ergometer training, and treadmill walking for 30 to 60 min per day, 5 days a week. Cardiothoracic ratio, NYHA class, heart rate, pulse oximeter saturation, plasma levels of human atrial natriuretic peptide and brain natriuretic peptide, tricuspid regurgitation, and right ventricular myocardial index (RV Tei index) were evaluated by echocardiography, lower extremity muscle strength, ambulation ability, Barthel index, and 6-minute walking distance at the beginning and end of cardiopulmonary rehabilitation.

RESULTS:

The average period of cardiopulmonary rehabilitation was 6.7 weeks. There was no deterioration in cardiothoracic ratio, human atrial natriuretic peptide, brain natriuretic peptide levels, tricuspid regurgitation, RV Tei index and pulse oximeter saturation. The results also showed decreased heart rate at rest (p = 0.007), and improved NYHA class (p = 0.010), lower extremity strength (p < 0.001), ambulation ability (p < 0.001), Barthel index (p < 0.001), and 6-minute walking distance (p = 0.001).

CONCLUSIONS:

Cardiopulmonary rehabilitation is safe and effective for idiopathic pulmonary arterial hypertension patients in NYHA class-III and IV during intravenous prostacyclin infusion without deterioration of cardiac functions, despite the conventional contraindication.

• Authors: Masayuki Uchi, Tsutomu Saji, Takashi Harada
• Journal: Journal of cardiology (J Cardiol) Vol. 46 Issue 5 Pg. 183-93 (Nov 2005) ISSN: 0914-5087 [Print] Netherlands
• PMID: 16320975 (Publication Type: English Abstract, Journal Article)

Chemical References

• Antihypertensive Agents
• Epoprostenol

Topics

• Activities of Daily Living
• Adolescent
• Adult
• Antihypertensive Agents (administration & dosage)
• Child
• Child, Preschool
• Combined Modality Therapy
• Epoprostenol (administration & dosage)
• Exercise Tolerance
• Female
• Heart Failure (complications)
• Humans
• Hypertension, Pulmonary (complications, drug therapy, rehabilitation)
• Infusions, Intravenous
• Male