Functional exercise capacity in patients with pulmonary arterial hypertension: a retrospective study

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Introduction: Pulmonary arterial hypertension (PAH) is a rare and complex condition characterized by an abnormal increase in mean pulmonary artery pressure (mPAP) at rest. Its progression impairs lung function, limits exercise capacity, and reduces quality of life. To assess functional capacity, the six-minute walk test (6MWT) is used to monitor disease progression and evaluate the effectiveness of therapeutic interventions. Objective: To characterize and interpret 6MWT results and compare physiological variables during the test in patients with PAH. Methods: Retrospective study based on electronic health record data from patients diagnosed with PAH through right heart catheterization (RHC). Data were collected from prior diagnoses, 6MWT results, and physiological variables, including peripheral oxygen saturation (SpO₂), heart rate (HR), dyspnea and fatigue symptoms assessed using the Borg scale, blood pressure (BP), and respiratory rate (RR). Patients without a confirmed PAH diagnosis via RHC were excluded from statistical analysis. Results: The study included 61 participants (37 women and 24 men), with a mean age of 51.9 years. The average walking distance in the 6MWT was 389.7 meters for the total sample, with subgroup distances of 416.1 meters in G1 (Mild/Moderate) and 367.3 meters in G2 (Severe). A comparison of physiological variables between G1 and G2 revealed similar changes during the 6MWT, except for RR and HR. G2 showed a greater increase in RR and an earlier rise in HR. Conclusion: The distance covered was shorter in G2 compared to G1. However, during the 6MWT, G2 exhibited a greater increase in RR and an earlier rise in HR, indicating reduced exercise capacity and suggesting the need for more frequent monitoring and careful observation.

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