{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:26:02Z","timestamp":1777497962622,"version":"3.51.4"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"23","license":[{"start":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T00:00:00Z","timestamp":1606176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Fondo de Investigaci\u00f3n Sanitaria"},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI17\/1515"],"award-info":[{"award-number":["PI17\/1515"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"Fondo Europeo de Desarrollo Regional","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Actelion"},{"name":"PHA-UK"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>This prospective, randomized, controlled, multicentre study aimed to evaluate efficacy and safety of exercise training in patients with pulmonary arterial (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>For the first time a specialized PAH\/CTEPH rehabilitation programme was implemented in 11 centres across 10 European countries. Out of 129 enrolled patients, 116 patients (58 vs. 58 randomized into a training or usual care control group) on disease-targeted medication completed the study [85 female; mean age 53.6\u2009\u00b1\u200912.5\u2009years; mean pulmonary arterial pressure 46.6\u2009\u00b1\u200915.1\u2009mmHg; World Health Organization (WHO) functional class II 53%, III 46%; PAH n\u2009=\u200998; CTEPH n\u2009=\u200918]. Patients of the training group performed a standardized in-hospital rehabilitation with mean duration of 25\u2009days [95% confidence interval (CI) 17\u201333\u2009days], which was continued at home. The primary endpoint, change of 6-min walking distance, significantly improved by 34.1\u2009\u00b1\u20098.3 m in the training compared with the control group (95% CI, 18\u201351\u2009m; P\u2009&amp;lt;\u20090.0001). Exercise training was feasible, safe, and well-tolerated. Secondary endpoints showed improvements in quality of life (short-form health survey 36 mental health 7.3\u2009\u00b1\u20092.5, P\u2009=\u20090.004), WHO-functional class (training vs. control: improvement 9:1, worsening 4:3; \u03c72 \u00a0P\u2009=\u20090.027) and peak oxygen consumption (0.9\u2009\u00b1\u20090.5\u2009mL\/min\/kg, P\u2009=\u20090.048) compared with the control group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This is the first multicentre and so far the largest randomized, controlled study on feasibility, safety, and efficacy of exercise training as add-on to medical therapy in PAH and CTEPH. Within this study, a standardized specialized training programme with in-hospital start was successfully established in 10 European countries.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehaa696","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T19:14:25Z","timestamp":1598642065000},"page":"2284-2295","source":"Crossref","is-referenced-by-count":103,"title":["Standardized exercise training is feasible, safe, and effective in pulmonary arterial and chronic thromboembolic pulmonary hypertension: results from a large European multicentre randomized controlled trial"],"prefix":"10.1093","volume":"42","author":[{"given":"Ekkehard","family":"Gr\u00fcnig","sequence":"first","affiliation":[{"name":"Centre for Pulmonary Hypertension, Thoraxklinik Heidelberg gGmbH at Heidelberg University Hospital, Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL) , R\u00f6ntgenstra\u00dfe 1, D-69126 Heidelberg, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6251-6887","authenticated-orcid":false,"given":"Alison","family":"MacKenzie","sequence":"additional","affiliation":[{"name":"Scottish Pulmonary Vascular Unit, Golden Jubilee National Hospital , Glasgow, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9896-8911","authenticated-orcid":false,"given":"Andrew J","family":"Peacock","sequence":"additional","affiliation":[{"name":"Scottish Pulmonary Vascular Unit, Golden Jubilee National Hospital , Glasgow, UK"}]},{"given":"Christina A","family":"Eichstaedt","sequence":"additional","affiliation":[{"name":"Centre for Pulmonary Hypertension, Thoraxklinik Heidelberg gGmbH at Heidelberg University Hospital, Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL) , R\u00f6ntgenstra\u00dfe 1, D-69126 Heidelberg, Germany"},{"name":"Laboratory for Molecular Diagnostics, Institute of Human Genetics, Heidelberg \u00a0 , Heidelberg, Germany"},{"name":"University \u00a0 , Heidelberg, Germany"}]},{"given":"Nicola","family":"Benjamin","sequence":"additional","affiliation":[{"name":"Centre for Pulmonary Hypertension, Thoraxklinik Heidelberg gGmbH at Heidelberg University Hospital, Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL) , R\u00f6ntgenstra\u00dfe 1, D-69126 Heidelberg, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2655-2965","authenticated-orcid":false,"given":"Robert","family":"Nechwatal","sequence":"additional","affiliation":[{"name":"Rehabilitation Center Koenigstuhl , Heidelberg, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5250-5022","authenticated-orcid":false,"given":"Silvia","family":"Ulrich","sequence":"additional","affiliation":[{"name":"Clinic of Pulmonology, University Hospital and University of Zurich , Zurich, Switzerland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3278-6277","authenticated-orcid":false,"given":"St\u00e9phanie","family":"Saxer","sequence":"additional","affiliation":[{"name":"Clinic of Pulmonology, University Hospital and University of Zurich , Zurich, Switzerland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3520-249X","authenticated-orcid":false,"given":"Maurizio","family":"Bussotti","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Department, IRCCS Maugeri Clinical Scientific Institutes , Milan, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2692-4925","authenticated-orcid":false,"given":"Marinella","family":"Sommaruga","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Department, IRCCS Maugeri Clinical Scientific Institutes , Milan, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1858-1152","authenticated-orcid":false,"given":"Stefano","family":"Ghio","sequence":"additional","affiliation":[{"name":"Divisione di Cardiologia, Fondazione IRCCS Policlinico S Matteo , Pavia, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6957-2985","authenticated-orcid":false,"given":"Lina","family":"Gumbiene","sequence":"additional","affiliation":[{"name":"Competence Centre of Pulmonary Hypertension, Vilnius University Hospital Santaros Klinikos , Vilnius, Lithuania"},{"name":"Faculty of Medicine, Institute of Clinical Medicine, Vilnius University , Vilnius, Lithuania"}]},{"given":"Egl\u0117","family":"Palevi\u010di\u016bt\u0117","sequence":"additional","affiliation":[{"name":"Competence Centre of Pulmonary Hypertension, Vilnius University Hospital Santaros Klinikos , Vilnius, Lithuania"},{"name":"Faculty of Medicine, Institute of Clinical Medicine, Vilnius University , Vilnius, Lithuania"}]},{"given":"Elena","family":"Jurevi\u010dien\u0117","sequence":"additional","affiliation":[{"name":"Competence Centre of Pulmonary Hypertension, Vilnius University Hospital Santaros Klinikos , Vilnius, 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