Exercise Program Improves Functional Capacity and Quality of Life in Uncorrected Atrial Septal Defect-Associated Pulmonary Arterial Hypertension: A Randomized-Control Pilot Study
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Objective To assess the effect of combined hospital and home-based exercise programs on functional capacity and quality of life (QoL) among uncorrected atrial septal defect-associated pulmonary arterial hypertension (ASD-PAH) patients. Methods This study was a randomized controlled trial with uncorrected ASD-PAH patients as the subjects. They were allocated randomly into control and exercise groups. Exercise group subjects performed hospital and home-based exercise programs, completing baseline 6-minute walking test (6MWT) and EQ-5D-3L QoL test (Utility Index and EQ-VAS scores), and were followed up for 12 weeks. The primary outcomes were 6MWT distance and EQ-5D-3L score at week 12. The N-terminal pro B-type natriuretic peptide (NT-proBNP) level was also assessed. A repeated-measure ANOVA was performed to detect endpoint differences over time. Results The exercise group contained 20 subjects and control group contained 19. In total, 19 exercise group subjects and 16 control group subjects completed the protocol. The 6MWT distance, Utility Index score, and EQ-VAS score incrementally improved significantly in the exercise group from baseline until week 12, with mean differences of 76.7 m (p<0.001), 0.137 (p<0.001) and 15.5 (p<0.001), respectively. Compared with the control group, the exercise group had significantly increased 6MWT distance and utility index score at week 12. The EQ-VAS score increased in the exercise group at week 12. The NTproBNP level decreased at week 12 in the exercise group. Conclusion Combined hospital and home-based exercise program added to PAH-targeted therapy, improving functional capacity and QoL in uncorrected ASD-PAH patients.
Abstract
Objective To assess the effect of combined hospital and home-based exercise programs on functional capacity and quality of life (QoL) among uncorrected atrial septal defect-associated pulmonary arterial hypertension (ASD-PAH) patients. Methods This study was a randomized controlled trial with uncorrected ASD-PAH patients as the subjects. They were allocated randomly into control and exercise groups. Exercise group subjects performed hospital and home-based exercise programs, completing baseline 6-minute walking test (6MWT) and EQ-5D-3L QoL test (Utility Index and EQ-VAS scores), and were followed up for 12 weeks. The primary outcomes were 6MWT distance and EQ-5D-3L score at week 12. The N-terminal pro B-type natriuretic peptide (NT-proBNP) level was also assessed. A repeated-measure ANOVA was performed to detect endpoint differences over time. Results The exercise group contained 20 subjects and control group contained 19. In total, 19 exercise group subjects and 16 control group subjects completed the protocol. The 6MWT distance, Utility Index score, and EQ-VAS score incrementally improved significantly in the exercise group from baseline until week 12, with mean differences of 76.7 m (p<0.001), 0.137 (p<0.001) and 15.5 (p<0.001), respectively. Compared with the control group, the exercise group had significantly increased 6MWT distance and utility index score at week 12. The EQ-VAS score increased in the exercise group at week 12. The NTproBNP level decreased at week 12 in the exercise group. Conclusion Combined hospital and home-based exercise program added to PAH-targeted therapy, improving functional capacity and QoL in uncorrected ASD-PAH patients.
참고문헌 (31)
- Lilly SL, "Pathophysiology of heart disease: a collaborative project of medical students and faculty" (2011), Lippincott Williams & Wilkins
- Galie N, "2015 ESC", ERS Guidelines for the diagnosis and treatment of pulmonary hypertension : The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology(ESC)and the European Respiratory Society(ERS) : Endorsed by : Association for European Paediatric and Congenital Cardiology(AEPC), International Society for Heart and Lung Transplantation(ISHLT), 2016, pp.37, 67~119
- D’Alto M, "Pulmonary hypertension related to congenital heart disease : a comprehensive review", Glob Cardiol Sci Pract, 2015, pp.42~ (2015)
- Dinarti LK, "The COngenital HeARt Disease in adult and Pulmonary Hypertension(COHARD-PH)registry : a descriptive study from single-center hospital registry of adult congenital heart disease and pulmonary hypertension in Indonesia", BMC Cardiovasc Disord, 20, pp.163~ (2020)
- Vijarnsorn C, "Contemporary survival of patients with pulmonary arterial hypertension and congenital systemic to pulmonary shunts", PLoS One, 13, pp.e0195092~ (2018)
- Sonu Sahni, "Pulmonary rehabilitation and exercise in pulmonary arterial hypertension: An underutilized intervention", Journal of exercise rehabilitation, 11(2), pp.74~79 (2015), 한국운동재활학회[DOI]
- Lilyasari O, "Economic evaluation of sildenafil for the treatment of pulmonary arterial hypertension in Indonesia", BMC Health Serv Res, 19, pp.573~ (2019)
- Dalla Vecchia LAD, "Exercise training in pulmonary arterial hypertension", J Thorac Dis, 10, pp.508~521 (2018)
- Gu S, "Systematic review of health-related quality of life in patients with pulmonary arterial hypertension", Pharmacoeconomics, 34, pp.751~770 (2016)
- Ehlken N, "Exercise training improves peak oxygen consumption and haemodynamics in patients with severe pulmonary arterial hypertension and inoperable chronic thrombo-embolic pulmonary hypertension : a prospective, randomized, controlled trial", Eur Heart J, 37, pp.35~44 (2016)
- American College of Sports Medicine, "ACSM’s resource manual for guideline for exercise testing and prescription" (2013), Lippincott Williams & Wilkins
- Mereles D, "Exercise and respiratory training improve exercise capacity and quality of life in patients with severe chronic pulmonary hypertension", Circulation, 114, pp.1482~1489 (2006)
- ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories, "ATS statement:guidelines for the six-minute walk test", Am J Respir Crit Care Med, 166, pp.111~117 (2002)
- Brooks R, "EuroQol : the current state of play", Health Policy, 37, pp.53~72 (1996)
- Tongsiri S, "Estimating population-based values for EQ-5D health states in Thailand", Value Health, 14, pp.1142~1145 (2011)
- Endarti D, "A comparison of EQ-5D-3L index scores using Malaysian, Singaporean, Thai, and UK value sets in Indonesian cervical cancer patients", Value Health Reg Issues, 15, pp.50~55 (2018)
- Ehlken N, "Economic evaluation of exercise training in patients with pulmonary hypertension", Lung, 192, pp.359~366 (2014)
- Fox BD, "Ambulatory rehabilitation improves exercise capacity in patients with pulmonary hypertension", J Card Fail, 17, pp.196~200 (2011)
- Richter MJ, "Effects of exercise training on pulmonary hemodynamics, functional capacity and inflammation in pulmonary hypertension", Pulm Circ, 7, pp.20~37 (2017)
- Amedro P, "Atrial septal defect and exercise capacity : value of cardio-pulmonary exercise test in assessment and follow-up", J Thorac Dis, 10(Suppl 24), pp.S2864~S2873 (2018)
- Nashat H, "Atrial septal defects and pulmonary arterial hypertension", J Thorac Dis, 10(Suppl 24), pp.S2953~S2965 (2018)
- Marra AM, "Pulmonary arterial hypertensionrelated myopathy : an overview of current data and future perspectives", Nutr Metab Cardiovasc Dis, 25, pp.131~139 (2015)
- Tran DL, "Pathophysiology of exercise intolerance in pulmonary arterial hypertension", Respirology, 23, pp.148~159 (2018)
- Dyer MT, "A review of health utilities using the EQ-5D in studies of cardiovascular disease", Health Qual Life Outcomes, 8, pp.13~ (2010)
- Pepke-Zaba J, "Sildenafil improves health-related quality of life in patients with pulmonary arterial hypertension", Chest, 133, pp.183~189 (2008)
- Chan L, "Benefits of intensive treadmill exercise training on cardiorespiratory function and quality of life in patients with pulmonary hypertension", Chest, 143, pp.333~343 (2013)
- Kukkonen M, "Quality of life among pulmonary hypertension patients in Finland", Eur Clin Respir J, 3, pp.26405~ (2016)
- Grunig E, "Safety and efficacy of exercise training in various forms of pulmonary hypertension", Eur Respir J, 40, pp.84~92 (2012)
- Eshtehardi P, "Effect of digoxin on mortality in patients with isolated right ventricular dysfunction secondary to severe pulmonary hypertension", J Am Coll Cardiol, 63(12_Suppl), pp.A750~ (2014)
- So PP, "Usefulness of beta-blocker therapy and outcomes in patients with pulmonary arterial hypertension", Am J Cardiol, 109, pp.1504~1509 (2012)
- van Campen JS, "Bisoprolol in idiopathic pulmonary arterial hypertension : an explorative study", Eur Respir J, 48, pp.787~796 (2016)
