Authors

1. Hornsby, Whitney E. PhD
2. Norton, Elizabeth L. MS
3. Fink, Samantha BS
4. Saberi, Sara MD, MS
5. Wu, Xiaoting PhD
6. McGowan, Cheri L. PhD
7. Brook, Robert D. MD
8. Jones, Lee W. PhD
9. Willer, Cristen J. PhD
10. Patel, Himanshu J. MD
11. Eagle, Kim A. MD
12. Lavie, Carl J. MD
13. Rubenfire, Melvyn MD
14. Yang, Bo MD, PhD

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,

O_2peak), 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

O_2peak was <36% predicted normative values (19.2 mL[middle dot]kg^-1.min^-1 vs 29.3 mL^.kg^-1.min^-1, P < .0001); the most marked impairment in

O_2peak 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.

O_2peak 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.