TY - JOUR
T1 - Multicenter randomized controlled trial of exercise in aortic dissection survivors
T2 - rationale, design, and initial hemodynamic data
AU - Toy, Yasmin A.
AU - House, Kayla N.
AU - Boyer, Leslie M.
AU - McNamara, Jennifer L.
AU - Hofmann-Bowman, Marion A.
AU - Eagle, Kim A.
AU - Lim, Michelle S.
AU - Braverman, Alan C.
AU - Prakash, Siddharth K.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - Aims: There are currently no evidence-based guidelines for exercise after thoracic aortic dissection (TAD), leading to highly variable recommendations that frequently lead patients to restrict their physical activities. This multicenter randomized controlled trial was intended to evaluate the safety and efficacy of a moderate intensity guided exercise program for TAD survivors. Methods: Participants were eligible if they had a Type A or Type B dissection at least 90 days before enrollment and could attend two in-person study visits. The guided exercise circuit consisted of six aerobic, isotonic, or isometric exercises that participants continued at home with virtual follow-up sessions. The primary endpoint is the change in the composite anxiety and depression PROMIS-29 T-score at 12 months. Secondary endpoints include changes in grip strength, weight, 24-h ambulatory blood pressure, and arterial biomechanical properties measured by central arterial waveform analysis. Results: Preliminary analysis of the first 81 enrolled participants demonstrated that the guided exercise circuit was completed safely and was not associated with severe hypertension, injury, or adverse cardiovascular events. At enrollment, adverse central waveform or ABPM characteristics were prevalent and were significantly associated with exertional hypertension. Conclusions: Guided exercise is safe for aortic dissection survivors. Follow-up of enrolled participants will conclude in October 2024.
AB - Aims: There are currently no evidence-based guidelines for exercise after thoracic aortic dissection (TAD), leading to highly variable recommendations that frequently lead patients to restrict their physical activities. This multicenter randomized controlled trial was intended to evaluate the safety and efficacy of a moderate intensity guided exercise program for TAD survivors. Methods: Participants were eligible if they had a Type A or Type B dissection at least 90 days before enrollment and could attend two in-person study visits. The guided exercise circuit consisted of six aerobic, isotonic, or isometric exercises that participants continued at home with virtual follow-up sessions. The primary endpoint is the change in the composite anxiety and depression PROMIS-29 T-score at 12 months. Secondary endpoints include changes in grip strength, weight, 24-h ambulatory blood pressure, and arterial biomechanical properties measured by central arterial waveform analysis. Results: Preliminary analysis of the first 81 enrolled participants demonstrated that the guided exercise circuit was completed safely and was not associated with severe hypertension, injury, or adverse cardiovascular events. At enrollment, adverse central waveform or ABPM characteristics were prevalent and were significantly associated with exertional hypertension. Conclusions: Guided exercise is safe for aortic dissection survivors. Follow-up of enrolled participants will conclude in October 2024.
KW - Exercise
KW - ambulatory blood pressure monitoring
KW - heritable thoracic aortic disease
KW - hypertension
KW - thoracic aortic aneurysm
KW - thoracic aortic dissection
UR - http://www.scopus.com/inward/record.url?scp=85194382909&partnerID=8YFLogxK
U2 - 10.20517/2574-1209.2023.149
DO - 10.20517/2574-1209.2023.149
M3 - Article
AN - SCOPUS:85194382909
SN - 2574-1209
VL - 8
JO - Vessel Plus
JF - Vessel Plus
M1 - 22
ER -