A Review of Exercise Interventions in Pulmonary Arterial Hypertension and Recommendations for Rehabilitation Programing

Pulmonary arterial hypertension (PAH) is characterized by impaired pulmonary vascular structure and function and is commonly associated with symptoms of dyspnea, fatigue, and potentially syncope. With chronic exposure to elevated pulmonary pressures, dramatic right ventricular dysfunction is common, thereby compromising cardiorespiratory fitness and increasing the risk of mortality. Collective investigative efforts, both at the preclinical and clinical levels, have established the safety and efficacy of regular exercise training in improving quality of life, cardiorespiratory fitness, and the physiologic profile of patients with PAH. Although the total volume of exercise training studies in patients with PAH pales in comparison with other chronic conditions, evidence for the optimal training recommendations is emerging. This review aims to provide a synopsis of the current exercise training literature in patients with PAH and provide preliminary training recommendations that can be implemented in rehabilitation programs.