title: Supervised exercise training improves exercise cardiovascular function in idiopathic pulmonary fibrosis.
abstract: BACKGROUND
  Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and fatal interstitial lung disease associated with cardiovascular impairments which compromise exercise tolerance and worsen prognosis.
  
  
  OBJECTIVE
  To examine the effect of participating in supervised exercise training (ET) program on cardiovascular function in patients with IPF.
  
  
  METHODS
  A randomized controlled study.
  
  
  METHODS
  Outpatient hospital.
  
  
  METHODS
  Thirty-two IPF patients (68±8 years).
  
  
  METHODS
  An ET group (N.=15) participated in a 12-week twice a week 60-minute supervised exercise program while a control group (N.=17) received usual care. At baseline and after the 12-week intervention all patients underwent resting echocardiography, cardiopulmonary exercise testing and N-terminal pro-brain natriuretic peptide (NT-proBNP) assessments.
  
  
  RESULTS
  The ET group significantly improved peak values of exercise cardiovascular indexes while the control group showed a trend of deterioration in the outcomes. The mean difference between the groups (95% CI) for circulatory power was 638 mLO2/kg/min/mmHg (95% CI: 197-1080) (P=0.006), cardiac power output 0.3 W (95% CI: 0.1 to 0.6) (P=0.041), and stroke work 312 mL/beat/mmHg (95% CI: 52-573) (P=0.02). No significant differences between groups were detected in most echocardiography measures and NT-proBNP. Changes in exercise cardiovascular indexes showed significant correlation with improvements in functional capacity, dyspnea and quality of life among ET group.
  
  
  CONCLUSIONS
  Participation in supervised ET program can improve exercise cardiovascular function in patients with IPF, however resting cardiac evaluations seem to be less sensitive to detect such changes.
  
  
  CONCLUSIONS
  These findings underscore the utility of supervised ET for cardiovascular enhancement which may also be clinically beneficial in reducing the cardiovascular morbidity and mortality in IPF patients.
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel - baruch.v1981@gmail.com.|Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal - baruch.v1981@gmail.com.|Division of Cardiology, Veterans Affairs Palo Alto Health Care System, Stanford University, Palo Alto, CA, USA - baruch.v1981@gmail.com.
authors.forename: Baruch
authors.initials: B
authors.lastname: Vainshelboim
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Mordechai R
authors.initials: MR
authors.lastname: Kramer
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Fox
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
authors.forename: Shimon
authors.initials: S
authors.lastname: Izhakian
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Echocardiography Unit, Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Sagie
authors.affiliation: Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Oliveira
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D015897:Comorbidity; D015150:Echocardiography, Doppler; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D007557:Israel / Q000453:epidemiology; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011788:Quality of Life; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016276:Ventricular Function / Q000502:physiology*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain