Effects Of Cpet-based Individualized Exercise Rehabilitation On Pulmonary Arterial Hypertension

Objective:To analyze the cardiopulmonary function of stable patients with the pulmonary arterial hypertension(PAH)and to explore effects of the cardiopulmonary exercise testing(CPET)-based precise individualized moderate-intensity exercise prescription on cardiopulmonary functional reserve and exercise capacity in patients with PAH.Methods:After the 6-min walking test(6MWT),31 stable PAH patients treated between April 2018 and July 2019 were chosen and randomly divided into an exercise group(n=16)and a control group(n=15),while 32 healthy counterparts were selected into a normal group.All subjects underwent CPET.All PAH patients were treated with ordinary targeted drugs,while those of the exercise group were additionally provided with an individualized moderate-intensity exercise prescription of?50%power treadmill training for 8 weeks,5 days/week based on CPET data of their own.CPET and 6MWT were conducted again after the intervention.Results:Before the intervention,the body mass index(BMI),force vital capacity(FVC),forced expiratory volume in one second(FEV1),maximum voluntary ventilation(MVV),anaerobic threshold(AT),peak heart rate(HRpeak),peak systolic blood pressure(SBPpeak),peak load power(WRpeak),peak oxygen uptake(V O2peak),peak oxygen pulse(V O2/HRpeak),peak cardiac output(COpeak),peak ventilatory equivalent(V Epeak),peak end-tidal carbon dioxide(PETCO2peak),peak pulse oxygen saturation(SpO2peak)and oxygen uptake efficiency plateau(OUEP)of the PAH group were significantly lower than the normal group(P<0.05).However,the rest heart rate(HRrest),peak dead space to tidal volume ratio(VD/VTpeak),minimum ventilatory equivalent for carbon dioxide(Lowest V E/V CO2)and slope of ventilatory equivalent for carbon dioxide(V E/V CO2 slope)of the PAH group were significantly higher than the normal group(P<0.05).After the exercise rehabilitation for 8 weeks,the average percentage of forced expiratory volume in the first second to forced vital capacity(FEV1/FVC),AT,WRpeak,V O2peak,V O2/HRpeak,COpeak and 6-minute walking distance(6MWD)of the exercise group increased significantly compared with the control group(P<0.05).In the exercise group,the average FVC,FEV1,MVV,AT,SBPpeak,WRpeak,V O2peak,V O2/HRpeak,COpeak,V Epeak,PETCO2peak,SpO2peak and 6MWD increased significantly after the treatment(P<0.05),while the average Lowest V E/V CO2 and V E/V CO2 slope decreased significantly(P<0.05).In the control group,the average FEV1,MVV,V O2peak(ml/min/kg)and V O2/HRpeak decreased significantly after the treatment(P<0.05).Conclusion:The holistic cardiopulmonary function of stable PAH patients is still lower than the normal group.CPET-based precise formulation individualized moderate-intensity exercise rehabilitation could enhance PAH the cardiopulmonary functional reserve and exercise capacity of patients with PAH.