Impact of a Cardiovascular Rehabilitation Program in Patients With Pulmonary Hypertension on the 6-Minute Walk Test

Introduction: Pulmonary hypertension (PH) is a rare and progressive disease characterized by increased pulmonary vascular resistance and pulmonary arterial pressure, leading to right heart failure, reduced exercise tolerance, functional impairment, and premature mortality. Assessment of functional capacity is a key component in the follow-up and risk stratification of these patients. The 6-minute walk test (6MWT) is a simple, submaximal, well-tolerated, and widely used tool for evaluating exercise capacity in patients with PH and is often more feasible in clinical practice than cardiopulmonary exercise testing. Materials and Methods: A longitudinal observational study was conducted including 58 patients with a confirmed diagnosis of PH who completed a cardiovascular rehabilitation program between 2015 and 2024. All patients were clinically stable and had no changes in oral therapy for at least three months before inclusion. Patients from different PH clinical groups were included. The 6MWT was performed before and after completion of the rehabilitation program. Statistical analysis was carried out using the paired t-test to compare pre- and post-intervention results. Results: The mean distance walked in the 6MWT increased from 304 meters at baseline to 358 meters after completion of the program, corresponding to a mean improvement of 54 meters. This increase was statistically significant (p < 0.001). A strong positive correlation was observed between baseline and final 6MWT distances, indicating that patients with better initial performance also achieved higher distances after rehabilitation. Conclusions: The cardiovascular rehabilitation program was effective in significantly improving functional capacity in patients with pulmonary hypertension, with a clinically meaningful increase in 6MWT distance, supporting the role of structured rehabilitation in this population.