Exercise Training and Cardiac Rehabilitation in Chronic Thromboembolic Pulmonary Hypertension.

Patients with chronic thromboembolic pulmonary hypertension (CTEPH) were traditionally advised against exercise training, based on unsubstantiated concerns that exercise-induced increases in pulmonary blood flow might aggravate vascular remodeling and trigger right ventricular decompensation. This dogma has been overturned by robust clinical evidence demonstrating that supervised exercise and respiratory training are both safe and effective. Exercise interventions consistently improve functional capacity, pulmonary hemodynamics, and health-related quality of life. Reflecting this paradigm shift, the latest European Society of Cardiology/European Respiratory Society guidelines endorse structured rehabilitation as an integral adjunct to established pharmacologic and interventional therapies.