Abstract
Background: Patients with pulmonary embolism (PE) may suffer from long-term consequences, including decreased functional capacity. Data on pulmonary rehabilitation (PR) in patients with PE are scarce, and no data on outpatient PR are available so far. Methods: We analyzed data of 22 PE patients who attended outpatient PR due to exertional dyspnea. Patients underwent a multi-professional 6-week PR program. The primary outcome was change in 6-min walk test (6MWT). Secondary outcomes included changes in strength and endurance tests. To assess long-term benefits, follow-up was performed a median of 39 months after PR. Results: Patients started PR a median of 19 weeks after the acute PE event. Their median age was 47.5 years, 33% were women and all presented with NYHA (New York Heart Association) class II and higher. After PR, patients showed significant and clinically relevant improvements in 6MWT (mean difference: 49.4 m [95% CI 32.0−66.8]). Similarly, patients increased performance in maximum strength, endurance and inspiratory muscle strength. At long-term follow-up, 78% of patients reported improved health. Conclusion: We observed significant improvements in exercise capacity in PE patients undergoing outpatient PR. The majority of patients also reported a long-term improvement in health status. Prospective studies are needed to identify patients who would benefit most from structured PR.
Highlights
Pulmonary embolism (PE) is an acute manifestation of venous thromboembolism (VTE), which is potentially life-threatening
We investigated the effect of outpatient pulmonary rehabilitation (PR) in patients suffering from exertional dyspnea after pulmonary embolism (PE)
Exercise training was well tolerated, and no adverse effects or complications occurred during outpatient PR
Summary
Pulmonary embolism (PE) is an acute manifestation of venous thromboembolism (VTE), which is potentially life-threatening. Of note, reduced physical performance, assessed with the 6-min walk test (6MWT), has been reported in approximately half of all patients with PE, which again is associated with decreased health-related quality of life [9,10,11]. Patient-reported outcome measures have indicated an acute decline in physical function after PE and a study on massive or submassive PE suggests that overall deconditioning rather than cardiopulmonary insufficiency imposes persistent symptoms [12,13]. Taken together, this highlights the need for measures to improve functional deficits in patients with PE. Prospective studies are needed to identify patients who would benefit most from structured PR
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