Integrated Mindfulness and Cardiopulmonary Rehabilitation Improves Cardiopulmonary Performance and Psychological Stress in Pulmonary Arterial Hypertension

Objective To investigate the effects of mindfulness‐based stress reduction (MBSR) combined with cardiopulmonary rehabilitation (CR) training on cardiopulmonary function, oxygen delivery efficiency, and psychological stress in patients with pulmonary arterial hypertension (PAH). Methods A total of 50 clinically stable PAH patients were randomly assigned to an intervention group ( N = 25) and a control group ( N = 25). The intervention group received a 6‐week program combining MBSR and standardized CR, while the control group received conventional health education and standard pharmacological management. Cardiopulmonary exercise capacity, hemodynamic parameters, and psychological stress levels were assessed before and after the intervention. Results After 6 weeks, the intervention group showed significantly improved percentage of predicted peak oxygen uptake (84.3 ± 12.1% vs. 71.2 ± 13.4%, p = 0.001), oxygen delivery (1650 ± 410 mL/min vs. 1388 ± 375 mL/min, p = 0.022), and arterial oxygen content (18.5 ± 2.1 mL/dL vs. 17.1 ± 1.8 mL/dL, p = 0.015). Hemodynamically, pulmonary vascular resistance significantly decreased (415 ± 265 vs. 586 ± 310 dyn·s/cm 5 , p = 0.040), and pulmonary artery compliance increased (2.12 ± 0.46 mL/mmHg vs. 1.76 ± 0.42 mL/mmHg, p = 0.009). In terms of psychological stress, the intervention group showed significantly lower scores in HAMA (11.28 ± 3.94 vs. 14.22 ± 4.06, p = 0.013), HAMD (11.36 ± 4.32 vs. 15.26 ± 4.89, p = 0.011), and SPBS (18.04 ± 4.83 vs. 23.02 ± 5.44, p = 0.001) compared with the control group. Conclusion MBSR combined with CR significantly improves cardiopulmonary exercise performance, oxygen transport capacity, and hemodynamic function in PAH patients, while also reducing psychological stress levels. This combined intervention demonstrates good safety and promising clinical applicability.