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. 2022 Apr 9;11(8):2107.
doi: 10.3390/jcm11082107.

Evolution of Early Postoperative Cardiac Rehabilitation in Patients with Acute Type A Aortic Dissection

Na Zhou  1 , Gabriel Fortin  2 , Maria Balice  1 , Oksana Kovalska  1 , Pascal Cristofini  1 , Francois Ledru  1 , Warner M Mampuya  2 , Marie-Christine Iliou  1
Affiliations

Evolution of Early Postoperative Cardiac Rehabilitation in Patients with Acute Type A Aortic Dissection

Na Zhou et al. J Clin Med. .

Abstract

Introduction: Surgically treated acute type A aortic dissection (ATAAD) patients are often restricted from physical exercise due to a lack of knowledge about safe blood pressure (BP) ranges. The aim of this study was to describe the evolution of early postoperative cardiac rehabilitation (CR) for patients with ATAAD.

Methods: This is a retrospective study of 73 patients with ATAAD who were referred to the CR department after surgery. An incremental symptom-limited exercise stress test (ExT) on a cyclo-ergometer was performed before and after CR, which included continuous training and segmental muscle strengthening (five sessions/week). Systolic and diastolic blood pressure (SBP and DBP) were monitored before and after all exercise sessions.

Results: The patients (78.1% male; 62.2 ± 12.7 years old; 54.8% hypertensive) started CR 26.2 ± 17.3 days after surgery. During 30.4 ±11.6 days, they underwent 14.5 ± 4.7 sessions of endurance cycling training, and 11.8 ± 4.3 sessions of segmental muscle strengthening. At the end of CR, the gain of workload during endurance training and functional capacity during ExT were 19.6 ± 10.2 watts and 1.2 ± 0.6 METs, respectively. The maximal BP reached during endurance training was 143 ± 14/88 ± 14 mmHg. The heart rate (HR) reserve improved from 20.2 ± 13.9 bpm to 33.2 ± 16.8 bpm while the resting HR decreased from 86.1 ± 17.4 bpm to 76.4 ± 13.3 bpm.

Conclusion: Early post-operative exercise-based CR is feasible and safe in patients with surgically treated ATAAD. The CR effect is remarkable, but it requires a close BP monitoring and supervision by a cardiologist and physical therapist during training.

Keywords: blood pressure; cardiac rehabilitation; exercise training; shear stresses; type A acute aortic dissection.

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Conflict of interest statement

The authors declare no conflict of interest.

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