title: Supervised exercise program improves aerobic fitness in patients awaiting abdominal aortic aneurysm repair.
abstract: BACKGROUND
  Aerobic fitness is an important predictor of postoperative outcome in major surgery. In this study, we assess the effects of a period of preoperative exercise on aerobic fitness as measured by cardiopulmonary exercise testing (CPET) in patients scheduled for abdominal aortic aneurysm (AAA) repair.
  
  
  METHODS
  As part of a randomized trial, the first patients recruited in the intervention group were enrolled in a supervised exercise program of six week duration. Treadmill CPET parameters were measured before and after exercise preoperatively for these patients. These parameters were as follows: peak oxygen uptake (VO2 peak), anaerobic threshold (AT), and ventilator equivalents for oxygen and carbon dioxide (VE/VO2 and VE/VCO2, respectively). Total exercise time and the time at which AT was achieved were also recorded. A comparison between pre- and postexercise parameters was made to detect for a possible improvement in aerobic fitness.
  
  
  RESULTS
  Twenty patients with AAA (17 men; mean age: 74.9 ± 5.9 years) were included in this study. Thirty-five percent of patients had a history of ischemic heart disease, 25% of obstructive airway disease, and 15% of cerebral vascular events. Seventy percent were previous smokers, and 15% were current smokers. Fifty-five percent of patients were taking aspirin and 75% were undergoing statin therapy. The median (interquartile range) VO2 peak at baseline was 18.2 (15.4-19.9) mL/kg/min, and after exercise was 19.9 (17.1-21.1; P = 0.048). Median AT at baseline was 12.2 (10.5-14.9), and 14.4 (12.3-15.4) after exercise (P = 0.023). Time of exercise tolerated also improved from a median of 379 to 604 sec (P = 0.001). No significant changes were seen in VE/VO2, VE/VCO2, or the time at which AT was achieved.
  
  
  CONCLUSIONS
  This study shows that cardiopulmonary aerobic fitness improves after a period of supervised exercise in patients scheduled for AAA repair. This is justification for a randomized trial to assess whether this affects morbidity and mortality after AAA repair.
authors: Academic Vascular Surgical Unit, University of Hull and Hull York Medical School, Hull, UK. Electronic address: hashem.barakat@gmail.com.
authors: Hashem M
authors: HM
authors: Barakat
authors: Academic Vascular Surgical Unit, University of Hull and Hull York Medical School, Hull, UK.
authors: Yousef
authors: Y
authors: Shahin
authors: Academic Vascular Surgical Unit, University of Hull and Hull York Medical School, Hull, UK.
authors: Rachel
authors: R
authors: Barnes
authors: Academic Vascular Surgical Unit, University of Hull and Hull York Medical School, Hull, UK.
authors: Risha
authors: R
authors: Gohil
authors: Academic Vascular Surgical Unit, University of Hull and Hull York Medical School, Hull, UK.
authors: Panos
authors: P
authors: Souroullas
authors: Academic Vascular Surgical Unit, University of Hull and Hull York Medical School, Hull, UK.
authors: Junaid
authors: J
authors: Khan
authors: Academic Vascular Surgical Unit, University of Hull and Hull York Medical School, Hull, UK.
authors: Peter T
authors: PT
authors: McCollum
authors: Academic Vascular Surgical Unit, University of Hull and Hull York Medical School, Hull, UK.
authors: Ian C
authors: IC
authors: Chetter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015308:Anaerobic Threshold; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017558:Elective Surgical Procedures; D057510:Endovascular Procedures; D004739:England; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D010101:Oxygen Consumption; D010809:Physical Fitness; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D014850:Waiting Lists