Key result
Moderate aerobic and low-intensity resistance exercise is safe post-ATAAD surgery despite systolic BP >160 mmHg.
Why the study?
ATAAD surgery corrects diseased vessels and reduces risk but does not redefine a safe exercise BP threshold, raising the question of whether this threshold can be upregulated to safely increase exercise intensity.
Does moderate-intensity aerobic exercise supplemented by low-intensity resistance training improve physical fitness safely in patients recovering from acute type A aortic dissection surgery?
Does moderate-intensity aerobic exercise supplemented by low-intensity resistance training improve physical fitness safely in patients recovering from acute type A aortic dissection surgery?
Moderate-intensity aerobic exercise with low-intensity resistance training is appropriate after ATAAD surgery, and current safe exercise BP thresholds may underestimate permissible training intensity.
Supports moderate-intensity exercise post-ATAAD; leaves open prospective trials to confirm safety and fitness gains.
(1) Background: Exercise is recommended to improve physical fitness in patients recovering from acute type A aortic dissection (ATAAD). However, surgery corrects the diseased blood vessels and reduces the risk of ATAAD, but it does not redefine a safe exercise blood pressure (BP) threshold. This review aimed to discuss whether the safe threshold of exercise BP can be upregulated after ATAAD surgery to increase exercise intensity with additional benefits. (2) Data sources: The PubMed databases were searched with the keywords "type A acute aortic dissection surgery", "exercise", "BP", "stress", and variations of these terms. (3) Study selection: Data from clinical trials, guidelines, and recent reviews were selected for review. (4) Results: Regular exercise can be considered a cardioprotective intervention for aortic dissection patients by attenuating hemodynamic responses at rest and during exercise. Previous studies have mainly focused on moderate-intensity aerobic exercise. In practice, the exercise systolic BP of some patients was higher than 160 mm Hg without adverse events, which indicates that the training intensity may be underestimated for patients after ATAAD surgery. Limited studies suggest a light-to-moderate resistance training for selected patients because it may cause a greater increase in BP. (5) Conclusions: Moderate-intensity continuous aerobic exercise supplemented by low-intensity resistance training is appropriate for cardiac rehabilitation after ATAAD surgery. The BP increase based on the normal exercise BP response, corresponding to the moderate-intensity is relatively safe. For high-risk post-ATAAD patients, considering the overall volume of training, personalizing the exercise regimen to remain within "safe" BP limits, and avoiding excessive fluctuations in BP should be the primary considerations for exercise training.
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Zhou et al. (2022) conducted a review in Acute type A aortic dissection (ATAAD). Exercise rehabilitation (aerobic and resistance training) was evaluated on Safe threshold of exercise blood pressure and adverse events. Moderate-intensity continuous aerobic exercise with low-intensity resistance training is appropriate after ATAAD surgery, as exercise systolic BP >160 mm Hg has been observed without adverse events.
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