Competitive sports participation in athletes with thoracic aortic aneurysms and dissections

Objectives Individuals with thoracic aortic disease (TAD) are frequently counseled to avoid intensive exercise. We surveyed athletes with TAD to assess their athletic participation and cardiovascular symptoms or outcomes related to competitive sporting events. Methods Participants were eligible for this study if they had a diagnosis of TAD and had participated in at least one competitive athletic event. Data was collected via customized REDCap surveys. The primary study outcomes were competitive event participation and event-related symptoms, comparing the five years before and after aortic diagnosis. Results Anonymous surveys were distributed to two social media groups. In all, 86 eligible participants completed surveys: 37 with aneurysms; 33 with dissections; and 16 with both diagnoses. After diagnosis, competitive sports participation decreased from a mean of 7 events per year (10% of cohort) to a mean of 0.8 events per year (1.2% of cohort, P<0.05). Seven respondents experienced event-related health symptoms, primarily related to running or endurance events. One participant was hospitalized after competition for arrhythmia. No acute dissections or aortic interventions occurred. Weekly exercise time was greater in those without event-related symptoms. In multivariate analyses, the number of cardiovascular medications was associated with event-related symptoms. Conclusion Athletic competition decreased significantly after TAD diagnosis. In a selected cohort of highly active individuals with TAD, competition led to frequent symptomatic episodes but did not result in acute aortic events. These observations suggest that regular exercise is generally well tolerated with relatively few symptomatic cardiovascular events for TAD patients who persist in competition.