Cardiopulmonary rehabilitation is a promising therapy for Pulmonary arterial hypertension (PAH) whose survival does not exceed 65% at five years. We performed a literature search about rehabilitation on PAH in MEDLINE, LILACS and COCHRANE databases, considering articles from 2005 to 2017. Fifteen articles were incorporated in the final analysis. We obtained information about safety parameters, type of exercises applied, duration and frequency of sessions. The interventions included aerobic, resistance and respiratory muscle training exercises. The results showed improvements in peak oxygen uptake, six minutes walking test, quality of life and inspiratory muscle strength, among others. We conclude that the evidence supports the recommendation of physical rehabilitation in selected patients with stable PAH as a complementary strategy to the available pharmacological therapy.
Cardiopulmonary exercise test for diagnostic and prognostic purposesThe functional assessment of patients with dyspnea usually uses static or submaximal exercise tests, which provide limited information because they do not expose patients to the real situation that causes exercise intolerance. The cardiopulmonary exercise test (CPET) is an increasingly used tool that can be used in these circumstances. It determines peak oxygen consumption, anaerobic threshold and cardiac and respiratory reserves, measuring oxygen uptake and carbon dioxide production during standardized exercise conditions. It is useful for risk assessment in cardiothoracic surgery and can provide valuable information such as the timing for transplant in patients with severe chronic disease. The test is non-invasive, has a short duration, and exhibits an adequate safety profile in specialized centers. It is mainly indicated for the dynamic evaluation of athletes or patients with heart, respiratory, and neuromuscular diseases, it is essential part of the study of dyspnea of unknown origin, and in the prognostic assessment of patients who face highly complex interventions. This review provides a comprehensive review of CPET with emphasis on its main indications in healthy people, athletes and, in particular, in functional evaluation of patients with exercise limitations in the context of their chronic diseases.
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