title: Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension.
abstract: To determine safety and efficacy of cardiac rehabilitation (CR) initiated immediately following balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) who presented with continuing exercise intolerance and symptoms on effort even after a course of BPA; 2-8 sessions/patient.
  
  
  
  Forty-one consecutive patients with inoperable CTEPH who underwent their final BPA with improved resting mean pulmonary arterial pressure of 24.7±5.5 mm Hg and who suffered remaining exercise intolerance were prospectively studied. Participants were divided into two groups just after the final BPA (6.8±2.3 days): patients with (CR group, n=17) or without (non-CR group, n=24) participation in a 12-week CR of 1-week inhospital training followed by an 11-week outpatient programme. Cardiopulmonary exercise testing, haemodynamics, and quality of life (QOL) were assessed before and after CR.
  
  
  
  No significant between-group differences were found for any baseline characteristics. At week 12, peak oxygen uptake (VO2), per cent predicted peak VO2 (70.7±9.4% to 78.2±12.8%, p<0.01), peak workload, and oxygen pulse significantly improved in the CR group compared with the non-CR group, with a tendency towards improvement in mental health-related QOL. Quadriceps strength and heart failure (HF) symptoms (WHO functional class, 2.2-1.8, p=0.01) significantly improved within the CR group. During the CR, no patient experienced adverse events or deterioration of right-sided HF or haemodynamics as confirmed via catheterisation.
  
  
  
  The combination of BPA and subsequent CR is a new treatment strategy for inoperable CTEPH to improve exercise capacity to near-normal levels and HF symptoms, with a good safety profile.
authors.affiliation: The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Fukui
authors.affiliation: The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ogo
authors.affiliation: The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takaki
authors.affiliation: The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Jin
authors.initials: J
authors.lastname: Ueda
authors.affiliation: The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tsuji
authors.affiliation: The Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Morita
authors.affiliation: The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Reon
authors.initials: R
authors.lastname: Kumasaka
authors.affiliation: The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Arakawa
authors.affiliation: The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Nakanishi
authors.affiliation: The Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
authors.affiliation: The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.affiliation: The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Norifumi
authors.initials: N
authors.lastname: Nakanishi
authors.affiliation: The Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Goto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000534:rehabilitation*; D062186:Arterial Pressure; D000072038:Cardiac Rehabilitation / Q000009:adverse effects / Q000379:methods*; D002908:Chronic Disease; D005080:Exercise Test; D005081:Exercise Therapy / Q000009:adverse effects; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology / Q000628:therapy*; D007564:Japan; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010101:Oxygen Consumption; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000503:physiopathology*; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome