Evidence mapPaperPMID 41428053Full record

SynthesisEuropean journal of applied physiology2026

Safety and efficacy of exercise training in patients with pulmonary hypertension: a systematic review and meta-analysis.

Ioannis Beis, Konstantina Dipla, Anna-Bettina Haidich, Afroditi Boutou, Athanasios Zacharias, Andreas Zafeiridis, Georgia Pitsiou

Abstract readSystematic ReviewMeta-AnalysisReview
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In one paragraph

Synthesis in European journal of applied physiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ioannis BeisRespiratory Failure Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Konstantina DiplaRespiratory Failure Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. kdipla@phed-sr.auth.gr.ORCID http://orcid.org/0000-0001-5902-3467
Anna-Bettina HaidichDepartment of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, Thessaloniki, Greece.ORCID http://orcid.org/0000-0001-5100-8799
Afroditi BoutouRespiratory Failure Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID http://orcid.org/0000-0001-7366-2038
Athanasios ZachariasRespiratory Failure Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Andreas ZafeiridisLaboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, 62100, Greece.ORCID http://orcid.org/0000-0002-0435-6659
Georgia PitsiouRespiratory Failure Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID http://orcid.org/0000-0001-7426-0890

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPulmonary hypertension (PH) is a progressive disease associated with reduced exercise tolerance and quality of life, despite advances in pharmacologic therapy. Exercise training has recently emerged as a potential non-pharmacological intervention, with growing evidence supporting its clinical benefits. However, optimal training modalities remain uncertain. This study aimed to synthesize current evidence and determine the overall efficacy and safety of exercise training in patients with PH.

methodsThis systematic review and meta-analysis evaluated the effects of structured exercise training programs in adults with Group 1 or 4 PH. PubMed and Cochrane Library were searched to identify randomized controlled trials and non-randomized interventional studies. Key outcomes included exercise capacity [Peak oxygen-uptake (VO2peak), 6-minute walk distance (6MWD)], quality of life, and safety. Data was pooled using a random-effects model, and study quality was assessed with validated risk of bias tools.

resultsThirteen studies, approximately 700 participants, were included. Exercise interventions significantly improved 6MWD (+ 52.5 m, 95%CI: 38.33–66.69, p < 0.001) and VO2peak (+ 1.65 mL/kg/min, 95%CI: 0.67–2.62, p < 0.001). Considerable heterogeneity was observed. Changes in quality-of-life scores were not statistically significant but trended positively. A reduction in pulmonary artery systolic pressure was noted [standardized mean difference (SMD) = − 0.21, 95%CI: −0.33 to − 0.10, p < 0.001], while resting heart rate remained unchanged (SMD = − 0.17, 95%CI: −0.55 to 0.21, p = 0.27). Across all studies, exercise training was consistently well-tolerated, with no serious adverse events directly linked to the interventions.

conclusionExercise training appears to be effective and safe for individuals with PH, improving functional capacity and cardiorespiratory fitness. These findings support its integration into multidisciplinary care.

Indexed as

Exercise TherapyHypertension, PulmonaryExercise ToleranceHumansOxygen ConsumptionQuality of LifeTreatment OutcomeCardiorespiratory fitnessExerciseExercise capacityExercise trainingPulmonary hypertensionPulmonary rehabilitation

Identifiers

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.