Alluvial diagram of breathlessness assessed on the mMRC scale. Perceived dyspnea as assessed by the modified Medical Research Council (mMRC) dyspnea scale, comparing the 4-month (left-hand side) and 24-month (right-hand side) follow-ups. 0p: “I only get breathless with strenuous exercise”, 1p: “I get short of breath when hurrying on level ground or walking up a slight hill”, 2p: “I walk slower than people of the same age on level ground because of breathlessness or have to stop for breath when walking at my own pace on level ground”, 3p: “I stop for breath after walking about 100 yards or after a few minutes on level ground”, 4p: “I am too breathless to leave the house” or “I become breathless when dressing”. Using the paired Wilcoxon signed-rank test a significant improvement was seen for the entire cohort at 24 months (p < 0.001).