Article

Few data are available regarding exercise testing in patients with abdominal
aortic aneurysm (AAA) disease. The purpose of this study was to evaluate safety
and to characterize the hemodynamic and cardiopulmonary (CPX) response to exercise in a large group of patients with AAA. Methods: Three hundred and six
patients with AAA>/=3.0 to </=5.0 cm (mean 72 +/- 8 years) underwent CPX as part
of a randomized trial of exercise training. CPX and hemodynamic responses,
ischemic events, rhythm disturbances, and risk estimates based on treadmill
scores were quantified and compared to an age-matched group of 2155 veterans
referred for exercise testing for clinical reasons. Results: Peak VO(2) was
similar between patients with AAA and the referral group (20.0 +/- 6 ml/kg/min;
77 percent of age-predicted and 20.3 +/- 7 ml/kg/min; 80 percent of
age-predicted, respectively). The incidence of exercise-induced hypotension and
hypertension was higher in AAA patients versus the referral group (2.9 and 3.6
percent vs <1.0 percent, p < 0.001), but there were no occurrences of ventricular
tachycardia (>/=3 beats) or other serious events in the AAA subjects. The Duke
Treadmill Score and VA Treadmill Scores, which estimate annual cardiovascular
events and all-cause mortality, respectively, were similar between groups.
Conclusions: Patients with AAA have a slightly higher incidence of hyper- and
hypotensive responses to exercise than age-matched referrals, but no serious
events related to CPX occurred. AAA patients can undergo maximal CPX safely and
have risk scores based on treadmill test results that are similar to age-matched
referral subjects.
These findings extend recent studies using sub-maximal
evaluations to stratify risk in patients considered for surgery, and support the
routine use of exercise testing for risk evaluation and the functional assessment
of patients with AAA.

Langue : ANGLAIS