French registry of cases of type I acute aortic dissection admitted to a cardiac rehabilitation center after surgery

Corone, Sonia; Iliou, Marie‐Christine; Pierre, B.; Feige, Jean-Michel; Odjinkem, Dominique; Farrokhi, Titi; Bechraoui, Faouzi; Hardy, Stephanie; Meurin, Philippe

doi:10.1097/hjr.0b013e32831fd6c8

Cited by 47 publications

(68 citation statements)

References 14 publications

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“…This, along with the likely prevalence of new‐onset anxiety and/or depression after AAD, suggests that cardiac rehabilitation after discharge may be beneficial. A study by Corone et al showed that cardiac rehabilitation after discharge, for patients experiencing a type A AAD, improved functionality, allowed patients to return to work earlier, increased muscular strength, and improved mental well‐being . In addition, patients expressed a desire for specific activity recommendations and felt that consequent activity restriction reduced their quality of life, suggesting a need for better patient education and further research to develop specific activity guidelines for this patient cohort.…”

Section: Discussionmentioning

confidence: 99%

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Survivors of Aortic Dissection: Activity, Mental Health, and Sexual Function

Chaddha

Kline–Rogers

Braverman

et al. 2015

Clinical Cardiology

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Background: Currently no research exists assessing lifestyle modifications and emotional state of acute aortic dissection (AAD) survivors. We sought to assess activity, mental health, and sexual function in AAD survivors. Hypothesis: Physical and sexual activity will decrease in AAD survivors compared to pre-dissection. Incidence of anxiety and depression will be significant after AAD. Methods: A cross sectional survey was mailed to 197 subjects from a single academic medical center (part of larger IRAD database). Subjects were ≥18 years of age surviving a type A or B AAD between 1996 and 2011. 82 surveys were returned (overall response rate 42%). Results: Mean age ± SD was 59.5 ± 13.7 years, with 54.9% type A and 43.9% type B patients. Walking remained the most prevalent form of physical activity (49 (60%) pre-dissection and 47 (57%) post-dissection). Physical inactivity increased from 14 (17%) before AAD to 20 (24%) after AAD; sexual activity decreased from 31 (38%) to 9 (11%) mostly due to fear. Most patients (66.7%) were not exerting themselves physically or emotionally at AAD onset. Systolic blood pressure (SBP) at 36 months post-discharge for patients engaging in ≥2 sessions of aerobic activity/week was 126.67 ± 10.30 vs. 141.10 ± 11.87 (p-value 0.012) in those who did not. Self-reported new-onset depression after AAD was 32% and also 32% for new-onset anxiety. Conclusions: Alterations in lifestyle and emotional state are frequent in AAD survivors. Clinicians should screen for unfounded fears or beliefs after dissection that may reduce function and/or quality of life for AAD survivors. IntroductionAcute aortic dissection (AAD) is a life-threatening emergency that involves a tear in the intimal wall. Studies have shown good long-term survival after initial treatment.

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Section: Discussionmentioning

confidence: 99%

“…Avoidance of sexual activity was also common postdissection and is unnecessary, with the most common reason reported being fear. Health care providers should evaluate sexual health and allay this unfounded fear.…”

Section: Discussionmentioning

confidence: 99%

Survivors of Aortic Dissection: Activity, Mental Health, and Sexual Function

Chaddha

Kline–Rogers

Braverman

et al. 2015

Clinical Cardiology

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“…To our knowledge, only 1 study to date has evaluated the safety and efficacy of exercise‐based cardiac rehabilitation in post‐AD patients. Corone et al reported on 33 French patients (25 men, 8 women) with type 1 DeBakey AD (mean age, 55.1 years) who underwent cardiac rehabilitation soon after surgical repair (mean, 27 days). Average resting SBP at hospital discharge was 120 mm Hg; most of the patients (97%) were taking β‐blockers.…”

Section: Physical Activity and Exercisementioning

confidence: 99%

Exercise and Physical Activity for the Post–Aortic Dissection Patient: The Clinician's Conundrum

Chaddha

Eagle

Braverman

et al. 2015

Clinical Cardiology

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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.

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“…Follow-up was for 1 year and included 3 complications in 2 patients that required additional thoracic surgery, although no deaths, cerebrovascular accidents, or myocardial infarctions were recorded. Ten of the 19 patients (53%) of working age were able to return to work ( 20 ). Th ese data substantiate the feasibility, relative safety, and eff ectiveness of exercise-based cardiac rehabilitation in post-AD survivors.…”

Section: Invited Commentarymentioning

confidence: 52%

Simulated Performance Testing to Determine the Aortic Dissection Patient's Potential for Vigorous Physical Activity

Franklin

2016

Baylor University Medical Center Proceedings

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French registry of cases of type I acute aortic dissection admitted to a cardiac rehabilitation center after surgery

Abstract: Physical training of moderate intensity seems feasible and beneficial in postsurgical type I aortic dissection patients.

Cited by 47 publications

References 14 publications

Survivors of Aortic Dissection: Activity, Mental Health, and Sexual Function

Survivors of Aortic Dissection: Activity, Mental Health, and Sexual Function

Exercise and Physical Activity for the Post–Aortic Dissection Patient: The Clinician's Conundrum

Simulated Performance Testing to Determine the Aortic Dissection Patient's Potential for Vigorous Physical Activity

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