Exercise training in patients with pulmonary arterial hypertension: a case report.

Purpose: To describe the benefits of a feasible, outpatient exercise training program on exercise tolerance and health-related quality of life (HRQL) in individuals with pulmonary arterial hypertension (PAH).

Methods: Case report on two subjects recruited from a tertiary care pulmonary hypertension clinic. Subject 1 was a 50-year-old male with idiopathic PAH. Subject 2 was a 54-year-old female with a 20+ year history of scleroderma and 6-year history of PAH. Both subjects underwent exercise training 3 times per week for 6 weeks using a cycle ergometer at workloads progressing from 50% to 80% of peak workload. Outcomes were assessed using cardiopulmonary exercise testing, six-minute walk test (6MWT), and HRQL using the Chronic Respiratory Disease Questionnaire (CRQ) and the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR).

Results: Both subjects made substantial improvements in oxygen consumption and workload at anaerobic threshold (improvements of 3.8 and 4.2 mL.kg(-1).min,(-1) 26 and 18 W, respectively) and 6MWT distance (from 496 to 586m and 416 to 517m, respectively). Only Subject 1 made substantial improvements in peak oxygen consumption (from 16.0 to 18.3 mL.kg(-1).min(-1)and from 15.0 to 15.6 mL.kg(-1).min,(-1) respectively) and peak work rate (from 112 to 130W and 66 to 69W, respectively). Both subjects demonstrated improved HRQL. No adverse events were noted.

Conclusions: A short and practical exercise training program can improve measures of workload, aerobic capacity, and HRQL in individuals with PAH with no adverse effects shown in these two case studies.