Effects of exercise training in patients with abdominal aortic aneurysm: preliminary results from a randomized trial.
OBJECTIVE
No effective medical therapy exists for early abdominal aortic aneurysm (AAA) disease. Lower extremity exercise improves aortic hemodynamics and reduces inflammation, but the safety and efficacy of exercise training in AAA disease is unknown. As an interim analysis of our prospective, randomized, longitudinal trial of exercise for AAA suppression, we investigated whether subjects with early disease could safely achieve target metabolic and hemodynamic goals.


METHODS
One hundred eight participants were randomized to exercise training (EX) or usual care (UC). EX subjects participated in a combination of in-house and home exercise training, with efforts directed toward moderate daily exercise participation. Comparisons were made between EX and UC subjects who completed 1 year of follow-up (n = 26 and 31, respectively, mean age 72 ± 8 years). EX and UC groups were compared for safety, cardiopulmonary exercise test responses, weekly energy expenditure, and biometric indices.


RESULTS
No paradoxical increase in AAA growth rate or adverse clinical events occurred as a consequence of exercise training. EX participants expended an average of 2269 ± 1207 kcal/wk and increased exercise capacity (42% increase in treadmill time, 24% increase in estimated metabolic equivalents, P = .01 and .08 between groups, respectively). EX participants demonstrated a significant reduction in C-reactive protein and tended to reduce waist circumference and waist-to-hip ratio (P = .06 and .07, respectively).


CONCLUSIONS
Preliminary analyses suggest that exercise training is well tolerated and sustainable in small AAA subjects over 1 year. Despite age and comorbidities, exercising AAA subjects achieve meaningful exercise targets and significantly modify activity-dependent variables.
Myers
Jonathan N
JN
Division of Cardiology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California 94304, USA. drj993@aol.com
White
Julie J
JJ
Narasimhan
Balasubramanian
B
Dalman
Ronald L
RL
D000368:Aged; D000704:Analysis of Variance; D000784:Aortic Dissection / Q000534:rehabilitation* / Q000628:therapy; D017544:Aortic Aneurysm, Abdominal / Q000534:rehabilitation* / Q000628:therapy; D001696:Biomechanical Phenomena; D002097:C-Reactive Protein; D018450:Disease Progression; D004562:Electrocardiography; D004734:Energy Metabolism; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D008297:Male; D012307:Risk Factors; D013997:Time Factors; D049629:Waist-Hip Ratio
D002097:C-Reactive Protein