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Studies Special exercise program helps patients with pulmonary hypertension
If the blood pressure in the lungs is significantly increased, doctors speak of pulmonary hypertension. This results in a constantly increased stress on the heart and over time fatigues the vital organ increasingly. In a recent study, scientists from Heidelberg University Hospital have demonstrated that special exercise training can help those affected to improve their cardiac output. The results of the current study were published in the journal "European Heart Journal".
The study shows that an individually adapted exercise program improves oxygen uptake and cardiac strength after just 15 weeks, according to the Heidelberg University Hospital. For the first time, researchers at the hospital have succeeded in directly demonstrating the effect on cardiac output by means of invasive catheter measurements. The training is a useful supplement to the drug therapy.
Patients with pulmonary hypertension can benefit significantly from a special exercise therapy. (Image: magicmine / fotolia.com) Narrowing of blood vessels in the lungs
According to the Heidelberg University Hospital, pulmonary hypertension is a chronic vascular disease that frequently occurs as a result of chronic obstructive pulmonary disease (COPD), pulmonary embolism, rheumatic diseases, congenital heart disease or heart failure. When the disease narrows the small blood vessels of the lungs and grow to some extent cancerous, explain the experts. As a result, the right half of the heart needs to expend a lot of power and the pumping power continues to decrease. "Those affected get into the slightest effort in severe respiratory distress and have a very poor prognosis without treatment," said the Department of the University Hospital. Although the disease is not curable until today, its progression can be significantly slowed down.
Cardiac output evaluated in 95 pulmonary hypertensive patients
The research team headed by Professor Ekkehard Grünig from the Thoraxklinik at Heidelberg University Hospital has examined the effect of the special exercise program on 95 medication-adjusted pulmonary hypertension patients in the context of the current study. For this purpose, the participants were divided into a training and a control group and the scientists determined the cardiac output of the subjects at the beginning and at the end of the 15-week observation period. This was done by measuring oxygen uptake and a right heart catheter examination at rest and under exercise. For right-handed catheter examinations, a probe was inserted into the right ventricle via a catheter in the jugular vein to record the pressure and thus also the pumping capacity, explain the experts at Heidelberg University Hospital.
Significant improvements after 15 weeks of training
The scientists found that after 15 weeks of training program, the subjects' maximum oxygen uptake was significantly improved under exercise, which is a sign that body muscles are working more effectively, according to the University Hospital's announcement. At the same time, the exercise program increased the pumping capacity of the right half of the heart by 20 percent under load. This equals about one liter more blood per minute that passes through the lungs. This "is the first study to record the effect of special pulmonary hypertension training on the cardiovascular system using invasive measurements," says first author Nicola Benjamin (née Ehlken). This was also the first proof that "a movement program can improve the cardiac output of seriously ill patients."
According to the researchers, further studies are now needed to pinpoint the impact of the training and the underlying mechanisms. However, the current results are important to understand the importance and importance of specific training in patients with pulmonary hypertension. Because "just a few years ago there was no way for patients with pulmonary hypertension to follow a guided physical training, because there is a risk that the disease will become worse due to excessive demands," says Nicola Benjamin.
Limitation in applicability
In the pulmonary hypertension center at the Thoraxklinik Heidelberg in cooperation with the Rehabilitation Clinic Königstuhl Heidelberg the special training for patients with pulmonary hypertension is offered. The successful and Europe-wide known movement therapy is now also recommended in addition to an optimally adjusted drug therapy in the guidelines, reports the University Hospital of Heidelberg. However, there is a crucial limitation in the offer. "For safety reasons, the training is only low-dose and should begin in a clinic specializing in pulmonary hypertension under the guidance of physicians and physiotherapists," emphasizes Professor Dr. med. Ekkehard Grünig. In most cases, the training must be adjusted daily at the beginning and any over-exertion could lead to a deterioration. (Fp)