Exercise in patients with pulmonary arterial hypertension.

Pulmonary arterial hypertension is a group of disorders defined by a progressive elevation of pulmonary vascular resistance in the small pulmonary arteries and arterioles. In its untreated form, the disease causes progressive dyspnea and severe activity limitation resulting in premature death due to right ventricular failure. However, the advent of multiple-targeted medical therapies has significantly altered the prognosis of this disorder, allowing patients to live longer with increased functional ability. Given the trend in prognosis and functionality, this review revisits the possible role for exercise training in patients with pulmonary arterial hypertension. The evidence suggesting that exercise may be safe in these patients is summarized and a potential exercise prescription is suggested.

[1]  F. Herth,et al.  Exercise and Respiratory Training Improve Exercise Capacity and Quality of Life in Patients With Severe Chronic Pulmonary Hypertension , 2006, Circulation.

[2]  R. Tkacova,et al.  Systemic inflammation in patients with COPD and pulmonary hypertension. , 2006, Chest.

[3]  M. LeWinter,et al.  Immune activation is associated with reduced skeletal muscle mass and physical function in chronic heart failure. , 2006, International journal of cardiology.

[4]  R. Speich,et al.  Pretransplantation bone disease in patients with primary pulmonary hypertension. , 2006, Chest.

[5]  R. Hopkins,et al.  Cognitive, emotional, and quality of life outcomes in patients with pulmonary arterial hypertension , 2006, Respiratory research.

[6]  Marion E. Schneider,et al.  Trauma-Induced Systemic Inflammatory Response versus Exercise-Induced Immunomodulatory Effects , 2006, Sports medicine.

[7]  R. Kaplan,et al.  Regular walking and long-term maintenance of outcomes after pulmonary rehabilitation. , 2006, Journal of cardiopulmonary rehabilitation.

[8]  S. Rubin,et al.  Inflammatory markers are associated with ventilatory limitation and muscle dysfunction in obstructive lung disease in well functioning elderly subjects , 2005, Thorax.

[9]  George A Mensah,et al.  Pulmonary hypertension surveillance--United States, 1980-2002. , 2005, Morbidity and mortality weekly report. Surveillance summaries.

[10]  Masayuki Uchi,et al.  [Feasibility of cardiopulmonary rehabilitation in patients with idiopathic pulmonary arterial hypertension treated with intravenous prostacyclin infusion therapy]. , 2005, Journal of cardiology.

[11]  G. Schuler,et al.  Exercise training in chronic heart failure: correlation between reduced local inflammation and improved oxidative capacity in the skeletal muscle , 2005, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[12]  E. Wouters,et al.  Raised CRP levels mark metabolic and functional impairment in advanced COPD , 2005, Thorax.

[13]  Y. Kondoh,et al.  Quadriceps weakness is related to exercise capacity in idiopathic pulmonary fibrosis. , 2005, Chest.

[14]  M. Piepoli.  Exercise training in heart failure , 2005, Current cardiology reports.

[15]  E. Wouters,et al.  Polyunsaturated fatty acids improve exercise capacity in chronic obstructive pulmonary disease , 2005, Thorax.

[16]  H. Katus,et al.  Respiratory muscle dysfunction in idiopathic pulmonary arterial hypertension , 2005, European Respiratory Journal.

[17]  B. Löwe,et al.  Anxiety and Depression in Patients With Pulmonary Hypertension , 2004, Psychosomatic medicine.

[18]  D. Mann,et al.  Exercise training and skeletal muscle inflammation in chronic heart failure: feeling better about fatigue. , 2003, Journal of the American College of Cardiology.

[19]  M. Humbert,et al.  Inflammation in pulmonary arterial hypertension , 2003, European Respiratory Journal.

[20]  A. Branzi,et al.  Prostanoids for Pulmonary Arterial Hypertension , 2003, American journal of respiratory medicine : drugs, devices, and other interventions.

[21]  G. Riegger,et al.  Hemodynamic effects of aerosolized iloprost in pulmonary hypertension at rest and during exercise. , 2002, Chest.

[22]  R. Barst,et al.  Bosentan therapy for pulmonary arterial hypertension. , 2002, The New England journal of medicine.

[23]  P. Jeffery.  Remodeling in asthma and chronic obstructive lung disease. , 2001, American journal of respiratory and critical care medicine.

[24]  D. Badesch,et al.  Effects of the dual endothelin-receptor antagonist bosentan in patients with pulmonary hypertension: a randomised placebocontrolled study , 2001, The Lancet.

[25]  J. E. Hansen,et al.  Exercise Pathophysiology in Patients With Primary Pulmonary Hypertension , 2001, Circulation.

[26]  K. Yarasheski,et al.  Resistance exercise decreases skeletal muscle tumor necrosis factor α in frail elderly humans , 2001 .

[27]  R. Barst,et al.  Effects of long-term infusion of prostacyclin on exercise performance in patients with primary pulmonary hypertension. , 1999, Chest.

[28]  D. Leyk,et al.  Hemodynamic responses during leg press exercise in patients with chronic congestive heart failure. , 1999, The American journal of cardiology.

[29]  V. Peinado,et al.  Inflammatory reaction in pulmonary muscular arteries of patients with mild chronic obstructive pulmonary disease. , 1999, American journal of respiratory and critical care medicine.

[30]  H. Roskamm,et al.  Comparison of left ventricular function during interval versus steady-state exercise training in patients with chronic congestive heart failure. , 1998, The American journal of cardiology.

[31]  M. Decramer,et al.  Exercise training in COPD patients: the basic questions. , 1997, The European respiratory journal.

[32]  E H Bergofsky,et al.  Survival in Patients with Primary Pulmonary Hypertension: Results from a National Prospective Registry , 1991 .