A systematic review found no controlled trials longitudinally evaluating the effect of exercise on survival or the risk of aortic dissection in patients with thoracic aortic disease.
Systematic Review
Does exercise and sports participation affect the risk of aortic dissection or survival in patients with thoracic aortic disease?
Despite current guidelines recommending patients with thoracic aortic disease avoid heavy exercise, there is a lack of longitudinal clinical evidence supporting this restriction, highlighting a critical need for prospective research.
INTRODUCTION: Current guidelines recommend patients with thoracic aortic disease (TAD) including inherited aortopathies to avoid heavy exercise. However, evidence supporting the negative advice on exercise is scarce. We aimed to provide an up-to-date systematic review of the available evidence on risks and benefits of exercise and sports participation in TAD patients. Areas covered: A systematic search was performed in Medline, Embase and Web of Science: thoracic aortic aneurysm or thoracic aortic dissection or inheritable aortopathies including Marfan Syndrome (MFS), Loeys-Dietz syndrome, Turner Syndrome, Ehlers-Danlos syndrome, bicuspid aortic valve (BAV) and sports, exercise or athletes. The resulting 1,652 manuscripts were reviewed by two independent observers. Eventually, 26 studies and 12 case-reports were included, reporting on thoracic aortic dimensions in athletes, exercise related acute aortic dissections, and exercise in BAV and MFS patients. Expert opinion: Blood pressure elevation during exercise may be associated with an increased risk of acute aortic dissection; however, no controlled trials have longitudinally evaluated the effect of exercise on survival or the risk of aortic dissection in TAD patients. Mouse-model studies suggest beneficial effects of exercise in the setting of a dilated aorta in MFS. There is a clear need for prospective research in this field.
Thijssen et al. (Tue,) conducted a systematic review in Thoracic aortic disease. Exercise and sports participation was evaluated on Risks and benefits of exercise and sports participation. A systematic review found no controlled trials longitudinally evaluating the effect of exercise on survival or the risk of aortic dissection in patients with thoracic aortic disease.