title: Exercise and Physical Activity for the Post-Aortic Dissection Patient: The Clinician's Conundrum.
abstract: Despite the paucity of evidence, it is often presumed, and is physiologically plausible, that sudden, acute elevations in blood pressure may transiently increase the risk of recurrent aortic dissection (AD) or rupture in patients with a prior AD, because a post-dissection aorta is almost invariably dilated and may thus experience greater associated wall stress as compared with a nondilated aorta. Few data are available regarding the specific types and intensities of exercise that may be both safe and beneficial for this escalating patient population. The purpose of this editorial/commentary is to further explore this conundrum for clinicians caring for and counseling AD survivors. Moderate-intensity cardiovascular activity may be cardioprotective in this patient cohort. It is likely that severe physical activity restrictions may reduce functional capacity and quality of life in post-AD patients and thus be harmful, underscoring the importance of further exploring the role of physical activity and/or structured exercise in this at-risk patient population.
authors.affiliation: Cardiovascular Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Ashish
authors.initials: A
authors.lastname: Chaddha
authors.affiliation: Cardiovascular Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Kim A
authors.initials: KA
authors.lastname: Eagle
authors.affiliation: Cardiovascular Division, Washington University, St. Louis, Missouri.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Braverman
authors.affiliation: Cardiovascular Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Eva
authors.initials: E
authors.lastname: Kline-Rogers
authors.affiliation: Cardiovascular Division, University of Minnesota Physicians Heart Practice, Minneapolis, Minnesota.
authors.forename: Alan T
authors.initials: AT
authors.lastname: Hirsch
authors.affiliation: Cardiovascular Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Robert
authors.initials: R
authors.lastname: Brook
authors.affiliation: Cardiovascular Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jackson
authors.affiliation: Cardiovascular Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Elise M
authors.initials: EM
authors.lastname: Woznicki
authors.affiliation: Cardiovascular Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Susan
authors.initials: S
authors.lastname: Housholder-Hughes
authors.affiliation: Thoracic Aortic Center, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Linda
authors.initials: L
authors.lastname: Pitler
authors.affiliation: Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Beaumont Health Center, Royal Oak, Michigan.
authors.forename: Barry A
authors.initials: BA
authors.lastname: Franklin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D062186:Arterial Pressure; D015444:Exercise; D005260:Female; D006339:Heart Rate; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011788:Quality of Life; D012008:Recurrence; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016896:Treatment Outcome