Cardiac rehabilitation in 311 patients with acute aortic dissection modestly improved exercise capacity and quality of life, with 0 adverse events reported during exercise testing or rehabilitation.
Systematic Review (n=311)
Does cardiac rehabilitation improve exercise capacity and quality of life in patients with acute aortic dissection?
Cardiac rehabilitation appears safe and may improve exercise capacity and quality of life in patients with acute aortic dissection, though high-quality randomized trial data is currently lacking.
Despite guideline recommendations, strategies for implementing cardiac rehabilitation (CR) in patients with acute aortic dissection (AAD) are not well established with little evidence to risk stratify prudent and effective guidelines for the many required variables. We conducted a systematic review of studies (2004-2023) reporting CR following type A (TA) and type B (TB) AAD. Our review is limited to open surgical repair for TA and medical treatment for TB. A total of 5 studies were included (4 TA-AAD and 1 TB-AAD) in the qualitative analysis. In general, observational data included 311 patients who had an overall favorable effect of CR in AAD consisting of a modestly improved exercise capacity and work load during cycle cardiopulmonary exercise test (TB-AAD), and improved quality of life (QoL). No adverse events were reported during symptom limited pre-CR treadmill or cycle exercise VO2 max or CR. Given the overall potential in this high risk population without adequate evidence for important variables such as safe time from post-op to CR, intensity of training, duration and frequency of sessions and followup it is time for a moderate sized well designed safe trial for patients’ post-op surgery for TA-AAD and medically treated TB-AAD who are treated with standardized evidence based medical therapy and physical therapy from discharge randomized to CR versus usual care. PROSPERO registry ID: CRD42023392896.
Carbone et al. (Sun,) conducted a systematic review in Acute aortic dissection (AAD) (n=311). Cardiac rehabilitation was evaluated on Exercise capacity, work load, and quality of life. Cardiac rehabilitation in 311 patients with acute aortic dissection modestly improved exercise capacity and quality of life, with 0 adverse events reported during exercise testing or rehabilitation.