Abstract
The aim of our study was to assess the effect of 8 weeks of pulmonary rehabilitation (PR) in patients with pulmonary embolism (PE) during unsupervised PR (unSPRgroup) versus supervised PR (SPRgroup) on cardiopulmonary exercise testing (CPET) parameters, sleep quality, quality of life and cardiac biomarkers (NT-pro-BNP). Fourteen patients with PE (unSPRgroup, n = 7, vs. SPRgroup, n = 7) were included in our study (age, 50.7 ± 15.1 years; BMI, 30.0 ± 3.3 kg/m2). We recorded anthropometric characteristics and questionnaires (Quality of life (SF-36) and Pittsburg sleep quality index (PSQI)), we performed blood sampling for NT-pro-BNP measurement and underwent CPET until exhausting before and after the PR program. All patients were subjected to transthoracic echocardiography prior to PR. The SPRgroup differed in mean arterial pressure at rest before and after the PR program (87.6 ± 3.3 vs. 95.0 ± 5.5, respectively, p = 0.010). Patients showed increased levels of leg fatigue (rated after CPET) before and after PR (p = 0.043 for SPRgroup, p = 0.047 for unSPRgroup) while the two groups differed between each other (p = 0.006 for post PR score). Both groups showed increased levels in SF-36 scores (general health; p = 0.032 for SPRgroup, p = 0.010 for unSPRgroup; physical health; p = 0.009 for SPRgroup, p = 0.022 for unSPRgroup) and reduced levels in PSQI (cannot get to sleep within 30-min; p = 0.046 for SPRgroup, p = 0.007 for unSPRgroup; keep up enough enthusiasm to get things done; p = 0.005 for SPRgroup, p = 0.010 for unSPRgroup) following the PR program. The ΝT-pro-BNP was not significantly different before and after PR or between groups. PR may present a safe intervention in patients with PE. The PR results are similar in SPRgroup and unSPRgroup.
Highlights
The incidence of pulmonary embolism (PE) following COVID-19 varies according to the population studied, the severity of COVID, the thromboprophylaxis dose, the screening protocol for VE, etc
We aimed to address theamong resultspatients of pulmonary rehabilitation (PR) insubjected exercise limitation andversus qualityunsupervised of life and examine differences to supervised exercise.possible differences among patients subjected to supervised versus unsupervised exercise
We did not observe major differences when SPRgroup was compared to unSPRgroup with the exception of reduced leg fatigue reported by the SPRgroup and the parameter “keep up enough enthusiasm to get things done” in Pittsburgh Sleep Quality Index (PSQI) which was in favor of the unSPRgroup
Summary
Pulmonary embolism (PE) is an acute and potentially fatal condition in which embolic material, usually a thrombus originating from the deep veins of the legs, blocks the pulmonary circulation resulting in impaired blood flow that may lead to right ventricle dysfunction [1]. PE and deep vein thrombosis are considered to be two manifestations of venous thromboembolism (VTE), which represents the third most common cardiovascular disorder in industrialized countries [2]. Patients with history of PE often exhibit functional limitations and decreased quality of life even years after the episode, a condition that is considered as a long-term complication of acute PE and termed “post-PE-syndrome”. PE in the setting of COVID-19 is a common complication, frequent in hospitalized patients [5], and is associated with its severity [6]. The incidence of PE following COVID-19 varies according to the population studied, the severity of COVID, the thromboprophylaxis dose, the screening protocol for VE, etc
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