PMID- 32642177
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220817
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 12
IP  - 5
DP  - 2020 May
TI  - Effectiveness and safety of exercise training and rehabilitation in pulmonary 
      hypertension: a systematic review and meta-analysis.
PG  - 2691-2705
LID - 10.21037/jtd.2020.03.69 [doi]
AB  - BACKGROUND: Pulmonary hypertension (PH) is a chronic progressive disease 
      characterized by increasing pulmonary vascular resistance, poor prognosis and 
      high disability rate. Although many targeted drugs for PH have been put to 
      clinical use, most patients still have poor exercise tolerance and quality of 
      life. Exercise training is considered to further improve exercise capacity and 
      quality of life in patients with PH, but it has not been fully studied and 
      utilized. The aim of this systematic review and meta-analysis is to evaluate the 
      effectiveness and safety of exercise training in patients with PH. METHODS: A 
      search was conducted for the meta-analysis using the databases PubMed, Embase, 
      Cochrane Library, including literature published before December 2018. The 
      primary outcome of this meta-analysis was a change in the 6-minute walk distance 
      (6MWD). In addition, peak oxygen uptake (PeakVO(2)), resting pulmonary arterial 
      systolic pressure (PASP(rest)), resting heart rate (HR(rest)), peak exercise 
      heart rate (HR(peak)), oxygen uptake anaerobic threshold (VO(2) at AT), maximum 
      workload and quality of life (QoL) were also assessed. RESULTS: A total of 651 
      patients in 17 studies were included. A meta-analysis showed that exercise 
      training was associated with significant improvement in the 6MWD [weighted mean 
      difference (WMD): 64.75 m (95% CI: 53.19-76.31 m, P<0.001)], peakVO(2) [WMD: 1.78 
      mL/min/kg (95% CI: 1.27-2.29 mL/min/kg, P<0.001)], HR(peak) [WMD: 11.07 beats/min 
      (95% CI: 8.04-14.11 beats/min, P<0.001)] and QoL measured by SF-36 questionnaire 
      subscale scores. Furthermore, exercise training is well tolerated, and no major 
      adverse event occurred related to exercise training. CONCLUSIONS: Exercise 
      training is associated with a significant improvement in exercise capacity, 
      cardiorespiratory fitness and quality of life among patients with PH and proved 
      to be safe for stable PH patients with optimization of medical therapy. However, 
      more large-scale multicenter studies are needed to confirm the effectiveness and 
      safety of exercise training in patients with PH.
CI  - 2020 Journal of Thoracic Disease. All rights reserved.
FAU - Zeng, Xiaomei
AU  - Zeng X
AD  - State Key Laboratory of Respiratory Disease, National Clinical Research Center 
      for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First 
      Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
AD  - General practice Department, Shenzhen Second People's Hospital, Shenzhen 
      University First Affiliated Hospital, Shenzhen 518035, China.
FAU - Chen, Haiming
AU  - Chen H
AD  - First Clinical Medical Institute of Guangzhou Medical University, Guangzhou 
      510182, China.
FAU - Ruan, Honglian
AU  - Ruan H
AD  - School of Public Health, Guangzhou Medical University, Guangzhou 511436, China.
FAU - Ye, Xiaojuan
AU  - Ye X
AD  - State Key Laboratory of Respiratory Disease, National Clinical Research Center 
      for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First 
      Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
AD  - General practice Department, Shenzhen Second People's Hospital, Shenzhen 
      University First Affiliated Hospital, Shenzhen 518035, China.
FAU - Li, Jieying
AU  - Li J
AD  - State Key Laboratory of Respiratory Disease, National Clinical Research Center 
      for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First 
      Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
FAU - Hong, Cheng
AU  - Hong C
AD  - State Key Laboratory of Respiratory Disease, National Clinical Research Center 
      for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First 
      Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
PMC - PMC7330286
OTO - NOTNLM
OT  - Pulmonary hypertension (PH)
OT  - exercise capacity
OT  - exercise training
OT  - rehabilitation
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at http://dx.doi.org/10.21037/jtd.2020.03.69). The authors have 
      no conflicts of interest to declare.
EDAT- 2020/07/10 06:00
MHDA- 2020/07/10 06:01
PMCR- 2020/05/01
CRDT- 2020/07/10 06:00
PHST- 2020/07/10 06:00 [entrez]
PHST- 2020/07/10 06:00 [pubmed]
PHST- 2020/07/10 06:01 [medline]
PHST- 2020/05/01 00:00 [pmc-release]
AID - jtd-12-05-2691 [pii]
AID - 10.21037/jtd.2020.03.69 [doi]
PST - ppublish
SO  - J Thorac Dis. 2020 May;12(5):2691-2705. doi: 10.21037/jtd.2020.03.69.