Cardiopulmonary exercise testing following open repair for a proximal thoracic aortic aneurysm or dissection Journal Article


Authors: Hornsby, W. E.; Norton, E. L.; Fink, S.; Saberi, S.; Wu, X.; McGowan, C. L.; Brook, R. D.; Jones, L. W.; Willer, C. J.; Patel, H. J.; Eagle, K. A.; Lavie, C. J.; Rubenfire, M.; Yang, B.
Article Title: Cardiopulmonary exercise testing following open repair for a proximal thoracic aortic aneurysm or dissection
Abstract: Purpose: There are limited data on cardiopulmonary exercise testing (CPX) and cardiorespiratory fitness (CRF), following open repair for a proximal thoracic aortic aneurysm or dissection. The aim was to evaluate serious adverse events, abnormal CPX event rate, CRF (peak oxygen uptake, o2peak), and blood pressure. Methods: Patients were retrospectively identified from cardiac rehabilitation participation or prospectively enrolled in a research study and grouped by phenotype: (1) bicuspid aortic valve/thoracic aortic aneurysm, (2) tricuspid aortic valve/thoracic aortic aneurysm, and (3) acute type A aortic dissection. Results: Patients (n = 128) completed a CPX a median of 2.9 mo (interquartile range: 1.8, 3.5) following repair. No serious adverse events were reported, although 3 abnormal exercise tests (2% event rate) were observed. Eighty-one percent of CPX studies were considered peak effort (defined as respiratory exchange ratio of ≥1.05). Median measured o2peak was <36% predicted normative values (19.2 mL·kg-1.min-1 vs 29.3 mL.kg-1.min-1, P <.0001); the most marked impairment in o2peak was observed in the acute type A aortic dissection group (<40% normative values), which was significantly different from other groups (P <.05). Peak exercise systolic and diastolic blood pressures were 160 mm Hg (144, 172) and 70 mm Hg (62, 80), with no differences noted between groups. Conclusions: We observed no serious adverse events with an abnormal CPX event rate of only 2% 3 mo following repair for a proximal thoracic aortic aneurysm or dissection. o2peak was reduced among all patient groups, especially the acute type A aortic dissection group, which may be clinically significant, given the well-established prognostic importance of reduced cardiorespiratory fitness. © 2020 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: adult; middle aged; major clinical study; prospective study; exercise; retrospective study; diastolic blood pressure; systolic blood pressure; echocardiography; cardiopulmonary exercise test; oxygen consumption; open surgery; cardiorespiratory fitness; human; male; female; priority journal; article; lung gas exchange; cardiopulmonary exercise testing; aortic dissection; heart rehabilitation; thoracic aortic aneurysm; bicuspid aortic valve; thoracic aorta aneurysm
Journal Title: Journal of Cardiopulmonary Rehabilitation and Prevention
Volume: 40
Issue: 2
ISSN: 1932-7501
Publisher: Lippincott Williams & Wilkins  
Date Published: 2020-03-01
Start Page: 108
End Page: 115
Language: English
DOI: 10.1097/hcr.0000000000000446
PUBMED: 31478921
PROVIDER: scopus
PMCID: PMC7048630
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Lee Winston Jones
    129 Jones