Efficacy and Safety of Exercise Training in Chronic Pulmonary Hypertension: A Systematic Review and Meta-Analysis
Background—Exercise training has been shown to improve cardiorespiratory fitness, physical capacity and quality of life in patients with cardiopulmonary conditions such as heart failure and COPD. However, its role in management of pulmonary hypertension is not well defined. In this study, we aim to evaluate the efficacy and safety of exercise training in patients with pulmonary hypertension.
Methods and Results—We included all prospective intervention studies that evaluated the efficacy and safety of exercise training in patients with pulmonary hypertension. Primary outcome of this meta-analysis was a change in six-minute walk distance (6MWD). We also assessed the effect of exercise on peak oxygen uptake (VO2peak), resting pulmonary arterial systolic pressure (PASP), peak exercise heart rate (HRpeak), and quality of life. A total of 16 studies with 434 exercise-training participants were included. In the pooled analysis, exercise training was associated with significant improvement in 6MWD [Weighted mean difference (WMD): 57.7 meters (95% CI: 42.5 to 72.8)], VO2peak [WMD = 1.7 ml/kg/min (95% CI: 1.3 to 2.0)], PASP [WMD = -3.6 mmHg (95% CI = -5.8 to -1.4)], HRpeak [WMD = 10.4 beats per min (95% CI: 5.5 to 15.3)], and quality of life as measured on SF-36 questionnaire subscale scores. Furthermore, exercise training was well tolerated with a low dropout rate and no major adverse events related to exercise training.
Conclusions—Exercise training in patients with pulmonary hypertension appears safe and is associated with a significant improvement in exercise capacity, pulmonary arterial pressure and quality of life.
- Received February 23, 2015.
- Accepted July 6, 2015.