Efficacy and Safety of Exercise Training in Chronic Pulmonary Hypertension Systematic Review and Meta-Analysis
Efficacy and Safety of Exercise Training in Chronic Pulmonary Hypertension Systematic Review and Meta-Analysis
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DOI：
10.1161/circheartfailure.115.002130
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发表时间：
2015-11-01
影响因子：
9.7
通讯作者：
Berry, Jarett D.
中科院分区：
文献类型：
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作者：
Pandey, Ambarish;Garg, Sushil;Berry, Jarett D.
背景-运动训练已被证明可以改善心肺功能，体能和心肺疾病患者的生活质量，如心力衰竭和慢性阻塞性肺疾病。然而，其在肺动脉高压管理中的作用尚未明确。在这项研究中，我们的目的是评估肺动脉高压患者运动训练的有效性和安全性。方法和结果-我们包括所有前瞻性干预研究，评估肺动脉高压患者运动训练的有效性和安全性。这项荟萃分析的主要结果是6分钟步行距离的变化。我们还评估了运动对峰值摄氧量、静息肺动脉收缩压、峰值运动心率和生活质量的影响。共有469名运动训练参与者参加了16项单独的训练研究。在汇总分析中，运动训练与6分钟步行距离的显著改善相关（加权平均差，53.3 m; 95%置信区间，39.5-67.2），峰值摄氧量（加权平均差，1.8 mL/kg/min; 95%置信区间，1.4-2.3），肺动脉收缩压（加权平均差，-3.7 mmHg; 95%置信区间，-5.4至-1.9），峰值运动心率（加权平均差，10次/min; 95%置信区间，6-15），以及SF-36问卷子量表评分测量的生活质量。此外，运动训练耐受性良好，辍学率低，没有重大不良事件与运动training. Conclusions运动训练肺动脉高压患者似乎是安全的，并与运动能力，肺动脉压和生活质量的显着改善。
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 chronic obstructive pulmonary disease. 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 6-minute walk distance. We also assessed the effect of exercise on peak oxygen uptake, resting pulmonary arterial systolic pressure, peak exercise heart rate, and quality of life. A total of 469 exercise-training participants enrolled in 16 separate training studies were included. In the pooled analysis, exercise training was associated with significant improvement in 6-minute walk distance (weighted mean difference, 53.3 m; 95% confidence interval, 39.5-67.2), peak oxygen uptake (weighted mean difference, 1.8 mL/kg per minute; 95% confidence interval, 1.4-2.3), pulmonary arterial systolic pressure (weighted mean difference, -3.7 mmHg; 95% confidence interval, -5.4 to -1.9), peak exercise heart rate (weighted mean difference, 10 beats per min; 95% confidence interval, 6-15), 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 were 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.