Exercise Therapy After Pulmonary Thromboendarterectomy or Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension

Exercise Therapy After Pulmonary Thromboendarterectomy or Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension: EXPECT-PH

This study is being completed to determine the feasibility and acceptability of completing a home-based, structured, low-to-moderate intensity exercise training program in chronic thromboembolic pulmonary hypertension (CTEPH) patients following surgical or percutaneous intervention. Eligible participants will be enrolled and have a 12 week home based exercise training program.

The study team hypothesizes that:

The following percentage of participants successfully complete the ramp-up phase of the exercise program:

• Greater or equal to 70% at end of week 7
• Greater or equal to 80% at end of week 10
• Greater or equal to 90% at end of week 12
• Greater or equal to 80% of participants will both complete ≥1 week of maintenance phase exercise and complete 12 weeks of the exercise intervention.
• Patients will have no adverse events, defined as syncope, worsening World Health Organization (WHO) functional class, pulmonary hypertension (PH) related hospitalization, or death, caused by the exercise intervention.

Inclusion Criteria:

• Chronic Thromboembolic Pulmonary Hypertension (CTEPH) patients post-Pulmonary Thromboendarterectomy (PTE) or Balloon Pulmonary Angioplasty (BPA)
• Planned follow-up at Michigan Medicine for at least one year
• Has access to an Android or iPhone with study supported operating software, is willing to install MyDataHelps application, and is willing to wear a smart watch while awake

Exclusion Criteria:

• Life expectancy under 1 year
• Orthopedic, neurological, or psychiatric condition limiting ability to actively engage in exercise training session
• Currently receiving palliative care and/or in hospice care
• Persistent severe Right Ventricular (RV) dysfunction on echocardiography post BPA or PTE
• Recently completed, current enrollment, or planned enrollment in pulmonary rehabilitation
• Moderate or severe obstructive lung disease or restrictive lung disease
• Arterial oxygen saturation (SpO2) <88% during 6 minute walk test(6MWT) on baseline home oxygen prescription
• Wrist too large to wear a smart watch comfortably.
• Participant noted to wear smart watch for less than 8 hours per day prior to intervention.
• Determined to be unsafe for participation in exercise therapy as assessed by the clinical team.
• Those with mobility issues that are unable to complete 6MWT.
• Participant has sex minute walk distance (6MWD) greater or equal to 90% predicted at visit 1.
• Pregnancy or lactation
• Non-English speaking