Division of Vascular Surgery, Department of Cardiovascular Surgery, Aarhus University Hospital, Aarhus, Denmark (Drs Jepsen, Pedersen, and Budtz-Lilly); and Division of Vascular and Endovascular Surgery, Cardiovascular Department, Trieste University Hospital Asuigi, Trieste, Italy (Dr D'Oria).
J Cardiopulm Rehabil Prev. 2023 May 1;43(3):156-161. doi: 10.1097/HCR.0000000000000743. Epub 2022 Nov 17.
Although physical exercise has established benefits for long-term cardiovascular health, concern regarding further aortic events has limited the evidence for exercise among aortic dissection (AD) patients. The objective was to perform a scoping review of the current concepts and gaps in the literature regarding the benefit and safety of cardiovascular testing and rehabilitation among post-AD patients.
A scoping review of the literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Eligibility criteria included any studies with AD in relation to exercise rehabilitation or testing and physical or mental health. Electronic databases were queried for relevant studies (last queried, November 1, 2021).
Six observational studies were included with a total of 381 patients with AD, all of whom underwent surgical intervention. Study heterogeneity prevented data synthesis and a formal systematic review, although four dominant themes emerged: cardiovascular-related outcomes, aorta-related outcomes, quality of life (QoL), and serious adverse events. Patients with AD have reduced baseline physical capacity and QoL. Rehabilitation programs may increase both physical status and QoL. Rates of serious adverse rates are minimal yet poorly defined.
Within the context of apparent benefits from cardiovascular testing and rehabilitation for patients with AD who have undergone intervention, this scoping review highlights the need for increased comparative research specific to exercise among patients with AD and outcomes such as mortality and reinterventions.
尽管身体锻炼对长期心血管健康有明确益处,但由于担心主动脉夹层 (AD) 患者的主动脉事件进一步加重,限制了其进行运动的证据。本研究旨在对 AD 患者心血管测试和康复的益处和安全性的相关文献进行全面综述,以了解目前的概念和研究空白。
根据系统评价和荟萃分析扩展的首选报告项目(PRISMA-ScR),对文献进行了全面综述。纳入标准包括与运动康复或测试以及身体或心理健康有关的 AD 的任何研究。电子数据库于 2021 年 11 月 1 日进行了相关研究查询。
共纳入 6 项观察性研究,共纳入 381 例 AD 患者,均接受了手术干预。研究的异质性妨碍了数据综合和正式的系统评价,尽管出现了四个主要主题:心血管相关结局、主动脉相关结局、生活质量 (QoL) 和严重不良事件。AD 患者的基线身体能力和 QoL 降低。康复计划可能会提高身体状况和 QoL。严重不良事件的发生率很低,但定义不佳。
在接受干预的 AD 患者进行心血管测试和康复似乎有益的情况下,本全面综述强调了需要针对 AD 患者进行更多特定于运动的比较研究,以及死亡率和再干预等结局。