Evaluation of a Rehabilitation Program With Blood Pressure-Guided Exercise Intensity Restrictions for Patients With Thoracic Aortic Dissection or Aneurysm.

Abstract

Purpose: Aortic disease presents a significant risk of mortality and morbidity, with hypertension considered the primary driver of disease progression. Blood pressure naturally increases during physical activity, and patients need guidance on the optimal level of exercise. The purpose of this study was to evaluate change in cardiopulmonary fitness after attending a rehabilitation program using blood pressure-guided exercise intensity.

Methods: The cohort included patients with thoracic aortic dissection (type A and B) and surgically operated thoracic aortic aneurysm. All participated in a rehabilitation program with maximum workload recommendations based on cardiopulmonary exercise tests which were performed before and after the rehabilitation program.

Results: 63 patients were included. At ventilatory threshold, workload increased by 17-32 watt and oxygen uptake by 1.8-2.9 ml/kg/min. 22 patients were able to perform both tests to exhaustion without exceeding blood pressure restrictions of 160-180 mmHg. These patients improved maximum workload by 20.6 watt (95% CI, 13.0-28.3) and peak oxygen uptake by 2.3 ml/kg/min (95% CI, 1.2-3.5). Only two cases of light dizziness at the end of test were reported.

Conclusions: Generally, patients with aortic disease improved oxygen uptake and workload during the rehabilitation program. One-third of the patients were able to perform both cardiopulmonary exercise tests to exhaustion without exceeding blood pressure restrictions. No serious adverse events occurred during test or exercise.