Cardiopulmonary exercise testing after proximal thoracic aortic repair was safe (0 serious adverse events), but VO2peak was significantly reduced vs normative values (19.2 vs 29.3 mL/kg/min, P<.0001).
Observational (n=128)
Is cardiopulmonary exercise testing safe and what is the cardiorespiratory fitness level in patients following open repair for a proximal thoracic aortic aneurysm or dissection?
Cardiopulmonary exercise testing appears safe approximately 3 months after open repair for proximal thoracic aortic aneurysm or dissection, though these patients exhibit significantly reduced cardiorespiratory fitness.
Absolute Event Rate: 19.2% vs 29.3%
p-value: p=<.0001
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, (Equation is included in full-text article.)O2peak), 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 (Equation is included in full-text article.)O2peak was <36% predicted normative values (19.2 mL·kgmin vs 29.3 mLkgmin, P < .0001); the most marked impairment in (Equation is included in full-text article.)O2peak 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. (Equation is included in full-text article.)O2peak 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.
Hornsby et al. (Mon,) conducted a observational in Proximal thoracic aortic aneurysm or dissection (n=128). Cardiopulmonary exercise testing (CPX) vs. Predicted normative values was evaluated on Peak oxygen uptake (VO2peak) (p=<.0001). Cardiopulmonary exercise testing after proximal thoracic aortic repair was safe (0 serious adverse events), but VO2peak was significantly reduced vs normative values (19.2 vs 29.3 mL/kg/min, P<.0001).