Benefits of skeletal-muscle exercise training in pulmonary arterial hypertension: The WHOLEi + 12 trial. (15th March 2017)

• Record Type: Journal Article
• Authors: González-Saiz, Laura; Fiuza-Luces, Carmen; Sanchis-Gomar, Fabian; Santos-Lozano, Alejandro; Quezada-Loaiza, Carlos A.; Flox-Camacho, Angela; Munguía-Izquierdo, Diego; Ara, Ignacio; Santalla, Alfredo; Morán, María; Sanz-Ayan, Paz; Escribano-Subías, Pilar; Lucia, Alejandro
• Is Part Of: International journal of cardiology. Volume 231(2017)
• Page Start: 277
• Page End: 283
• Publication Date: 2017-03-15
• Subjects: Resistance exercise -- Pulmonary disease -- VO2peak -- NT-proBNP -- Cardio-pulmonary exercise testing; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2016.12.026
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Pulmonary arterial hypertension is often associated with skeletal-muscle weakness. The purpose of this randomized controlled trial was to determine the effects of an 8-week intervention combining muscle resistance, aerobic and inspiratory pressure-load exercises on upper/lower-body muscle power and other functional variables in patients with this disease. Methods: Participants were allocated to a control (standard care) or intervention (exercise) group ( n = 20 each, 45 ± 12 and 46 ± 11 years, 60% women and 10% patients with chronic thromboembolic pulmonary hypertension per group). The intervention included five, three and six supervised (inhospital) sessions/week of aerobic, resistance and inspiratory muscle training, respectively. The primary endpoint was peak muscle power during bench/leg press; secondary outcomes included N-terminal pro-brain natriuretic peptide levels, 6-min walking distance, five-repetition sit-to-stand test, maximal inspiratory pressure, cardiopulmonary exercise testing variables (e.g., peak oxygen uptake), health-related quality of life, physical activity levels, and safety. Results: Adherence to training sessions averaged 94 ± 0.5% (aerobic), 98 ± 0.3% (resistance) and 91 ± 1% (inspiratory training). Analysis of variance showed a significant interaction (group × time) effect for leg/bench press ( P < 0.001/ P = 0.002), with both tests showing an improvement in the exercise group ( P < 0.001) but not in controls ( P > 0.1). We found a significant interaction effect ( P < 0.001) for five-repetition sit-to-stand test, maximal inspiratory pressure and peak oxygen uptake ( P < 0.001), indicating a training-induced improvement. No major adverse event was noted due to exercise. Conclusions: An 8-week exercise intervention including aerobic, resistance and specific inspiratory muscle training is safe for patients with pulmonary arterial hypertension and yields significant improvements in muscle power and other functional variables.