title: Cardiopulmonary exercise testing in small abdominal aortic aneurysm: profile, safety, and mortality estimates.
abstract: OBJECTIVE
  Few data are available regarding exercise testing in patients with abdominal aortic aneurysm (AAA) disease. The purpose of this study was to evaluate safety and to characterize the hemodynamic and cardiopulmonary (CPX) response to exercise in a large group of patients with AAA.
  
  
  METHODS
  Three hundred and six patients with AAA ≥3.0 to ≤5.0 cm (mean 72 ± 8 years) underwent CPX as part of a randomized trial of exercise training. CPX and hemodynamic responses, ischemic events, rhythm disturbances, and risk estimates based on treadmill scores were quantified and compared to an age-matched group of 2155 veterans referred for exercise testing for clinical reasons.
  
  
  RESULTS
  Peak VO(2) was similar between patients with AAA and the referral group (20.0 ± 6 ml/kg/min; 77 percent of age-predicted and 20.3 ± 7 ml/kg/min; 80 percent of age-predicted, respectively). The incidence of exercise-induced hypotension and hypertension was higher in AAA patients versus the referral group (2.9 and 3.6 percent vs <1.0 percent, p < 0.001), but there were no occurrences of ventricular tachycardia (≥3 beats) or other serious events in the AAA subjects. The Duke Treadmill Score and VA Treadmill Scores, which estimate annual cardiovascular events and all-cause mortality, respectively, were similar between groups.
  
  
  CONCLUSIONS
  Patients with AAA have a slightly higher incidence of hyper- and hypotensive responses to exercise than age-matched referrals, but no serious events related to CPX occurred. AAA patients can undergo maximal CPX safely and have risk scores based on treadmill test results that are similar to age-matched referral subjects. These findings extend recent studies using sub-maximal evaluations to stratify risk in patients considered for surgery, and support the routine use of exercise testing for risk evaluation and the functional assessment of patients with AAA.
authors: Division of Cardiology, Veterans Affairs Palo Alto Health Care System/Stanford University, Palo Alto, CA 94304, USA. drj993@aol.com
authors: Jonathan
authors: J
authors: Myers
authors: Alyssa
authors: A
authors: Powell
authors: Kimberly
authors: K
authors: Smith
authors: Holly
authors: H
authors: Fonda
authors: Ronald L
authors: RL
authors: Dalman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D002140:California / Q000453:epidemiology; D018450:Disease Progression; D004562:Electrocardiography; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends