Cardiac rehabilitation in patients with thoracic aortic disease: Review of the literature and design of a program

Abstract

The pathology of aortic dilatation is still not fully understood. Increased aortic dimensions are found in patients with hypertension, bicuspid aortic valve or various elastopathies, most commonly with Marfan syndrome. In general, there is only a mild adaptation of the aortic root to physical activity. Although there is no clear evidence that physical activity significantly influences aortic root size, individuals with thoracic aortic disease (TAD) are generally discouraged from engaging in sports activities. Most of them resign from sports and moves toward sedentary life with all of its consequences such as obesity, hypertension, and worsening lipid profile. There are also many sedentary individuals with TAD who had never even started any physical activity for the same reasons. Athletes who survived aortic dissection may also be stressed about regaining sports activity. On the other hand, there is mounting data on the potentially beneficial influence of mild-to-moderate exercise in patients with TAD. Therefore, a design of a comprehensive, monitored, cardiac rehabilitation program for patients with TAD, presented in the current manuscript, is highly warranted. It is based on an available data and should help both doctors and patients with TAD to overcome restrictions regarding the safety of sports activity. If proven successful, it may be used in the future for exercise prescription in patients with TAD in the community setting.