400 Section - Individualized Exercise Rehabilitation Guided by Cardiopulmonary Exercise Testing Improves Cardiorespiratory Function, Systemic Inflammation, and Quality of Life in Pulmonary Arterial Hypertension

 To evaluate the efficacy and safety of individualized exercise rehabilitation based on cardiopulmonary exercise testing (CPET) in improving cardiorespiratory function, systemic inflammatory, and quality of life in patients with pulmonary arterial hypertension (PAH).

Design:

 In this prospective, single-center trial, 120 patients with stable PAH between January and December 2024 were enrolled. All participants were randomly assigned (1:1) to the control group (standard pharmacotherapy, n = 60) or the intervention group (standard pharmacotherapy with individualized exercise rehabilitation, n = 60). All patients were treatment 12 weeks. Primary outcomes were changes in VO2peak at 12 weeks. The secondary outcomes included VE/VCO2 slope, echocardiographic parameters, 6-min walking distance (6MWD), NT-proBNP, inflammatory biomarkers, and HRQoL scores.

Results:

 After treatment 12 weeks, VO2peak increased by 2.96 ± 0.83 mL·kg⁻¹·min⁻¹, VE/VCO2 slope declined by 3.87 ± 1.09, 6MWD improved by 59 ± 18 m, and NT-proBNP decreased by 27.3 % in the intervention group (all P< 0.05). The improvements of these factors were significantly greater in the intervention group than in the control group (all P < 0.05). Serum IL-6, TNF-α, and CRP levels decreased by 3.26 ng/L, 0.92 ng/L, and 2.94 mg/L, respectively (all P < 0.01). The decreased of these factors were significantly greater in the intervention group than in the control group (all P < 0.05). The improvement of SF-36 physical component summary and CAMPHOR symptom scores in the intervention group were significantly greater compare to in the control group (both P < 0.001). The serious adverse events did not differ between the two groups (P = 0.63).

Conclusion:

 12 weeks of CPET-guided individualized exercise rehabilitation significantly enhances cardiorespiratory function, attenuates systemic inflammation, and improves HRQoL in patients with PAH.