Article

Pulmonary arterial hypertension (PAH) is characterized by reduced functional
capacity and health-related quality of life. Despite the progress made in recent
years in disease-targeted therapies with improvement in prognosis, PAH patients
often experience progressive exercise intolerance. Exercise rehabilitation is
beneficial and has become a standard of care in patients with systolic heart
failure and chronic obstructive pulmonary disease.
However, although PAH patients
present with similar exertional limitation and often share common hemodynamic,
ventilatory, and skeletal muscle derangements, exercise rehabilitation was
discouraged in PAH patients because of concerns of clinical deterioration and
adverse outcomes. In recent years, several small-scale studies have demonstrated
that closely supervised and monitored exercise training programs may have
potential benefits in the management of stable PAH patients, improving exercise
capacity and quality of life, with an acceptable low risk of adverse events in
the studied populations.
This review describes the emerging clinical data
supporting the efficacy and safety of exercise training in PAH patients. The review provides a perspective on the pathophysiological impairments contributing
to exercise intolerance in these patients and critically project from the proven
evidence-based benefits of cardiopulmonary rehabilitation in chronic heart
failure and chronic obstructive pulmonary disease on the PAH population.

Langue : ANGLAIS