Randomised controlled trial examining the effect of an outpatient exercise training programme on haemodynamics and cardiac MR parameters of right ventricular function in patients with pulmonary arterial hypertension: the ExPAH study protocol.
Pulmonary hypertension (PH) is a potentially life-threatening condition characterised by elevated pulmonary artery pressure. Early stage PH patients are often asymptomatic. Disease progression is associated with impairment of right ventricular function and progressive dyspnoea. Current guidelines recommend exercise training (grade IIa, level B). However, many questions remain regarding the mechanisms of improvement, intensity of supervision and optimal frequency, duration and intensity of exercise. This study will assess the effect of an outpatient rehabilitation programme on haemodynamics and cardiac right ventricular function in patients with pulmonary arterial hypertension (PAH), a subgroup of PH.



This randomised controlled trial involves both a major urban tertiary and smaller regional hospital in New South Wales, Australia. The intervention will compare an outpatient rehabilitation programme with a control group (home exercise programme). Participants will be stable on oral PAH-specific therapy. The primary outcome measure will be right ventricular ejection fraction measured by cardiac MRI. Secondary outcomes will include haemodynamics measured by right heart catheterisation, endurance, functional capacity, health-related quality of life questionnaires and biomarkers of cardiac function and inflammation.



Ethical approval has been granted by St Vincent's Hospital, Sydney (HREC/14/SVH/341). Results of this study will be disseminated through presentation at scientific conferences and in scientific journals.



ACTRN12615001041549; pre-results.
University of New South Wales Rural Clinical School, Coffs Harbour, New South Wales, Australia.|Coffs Harbour Health Campus, Coffs Harbour, New South Wales, Australia.
Karen S W
0000-0002-0089-8151
KS
Chia
Sacred Heart Rehabilitation, St Vincent's Health, Coffs Harbour, New South Wales, Australia.|University of New South Wales, Coffs Harbour, New South Wales, Australia.|St Vincent's Hospital Sydney, Coffs Harbour, New South Wales, Australia.
Steven G
SG
Faux
University of New South Wales Rural Clinical School, Coffs Harbour, New South Wales, Australia.|Coffs Harbour Health Campus, Coffs Harbour, New South Wales, Australia.|Mid-North Coast Arthritis Clinic, Coffs Harbour, New South Wales, Australia.
Peter K K
PK
Wong
University of New South Wales, Coffs Harbour, New South Wales, Australia.|St Vincent's Hospital Sydney, Coffs Harbour, New South Wales, Australia.
Cameron
C
Holloway
University of New South Wales Rural Clinical School, Coffs Harbour, New South Wales, Australia.|Epidemiology and Health Analytics Department, Western Sydney Local Health District, Coffs Harbour, New South Wales, Australia.
Hassan
0000-0001-7404-8144
H
Assareh
University of New South Wales Rural Clinical School, Coffs Harbour, New South Wales, Australia.
Craig S
CS
McLachlan
University of New South Wales, Coffs Harbour, New South Wales, Australia.|St Vincent's Hospital Sydney, Coffs Harbour, New South Wales, Australia.
Eugene
E
Kotlyar
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000534:rehabilitation*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010045:Outpatients; D011788:Quality of Life; D012044:Regression Analysis; D012107:Research Design; D016278:Ventricular Function, Right; D014797:Vital Capacity; D055815:Young Adult
D015415:Biomarkers
Pulmonary hypertension; cardiac magnetic resonance imaging; haemodynamics; outpatient exercise training