Hashem M. Barakat
Supervised exercise program improves aerobic fitness in patients awaiting abdominal aortic aneurysm repair
Barakat, Hashem M.; Shahin, Yousef; Barnes, Rachel; Gohil, Risha; Souroullas, Panos; Khan, Junaid; McCollum, Peter T.; Chetter, Ian C.
Authors
Yousef Shahin
Rachel Barnes
Risha Gohil
Panos Souroullas
Junaid Khan
Peter T. McCollum
Professor Ian Chetter I.Chetter@hull.ac.uk
Professor of Vascular Surgery
Abstract
Background
Aerobic fitness is an important predictor of postoperative outcome in major surgery. In this study, we assess the effects of a period of preoperative exercise on aerobic fitness as measured by cardiopulmonary exercise testing (CPET) in patients scheduled for abdominal aortic aneurysm (AAA) repair.
Methods
As part of a randomized trial, the first patients recruited in the intervention group were enrolled in a supervised exercise program of six week duration. Treadmill CPET parameters were measured before and after exercise preoperatively for these patients. These parameters were as follows: peak oxygen uptake (VO2 peak), anaerobic threshold (AT), and ventilator equivalents for oxygen and carbon dioxide (VE/VO2 and VE/VCO2, respectively). Total exercise time and the time at which AT was achieved were also recorded. A comparison between pre- and postexercise parameters was made to detect for a possible improvement in aerobic fitness.
Results
Twenty patients with AAA (17 men; mean age: 74.9 ± 5.9 years) were included in this study. Thirty-five percent of patients had a history of ischemic heart disease, 25% of obstructive airway disease, and 15% of cerebral vascular events. Seventy percent were previous smokers, and 15% were current smokers. Fifty-five percent of patients were taking aspirin and 75% were undergoing statin therapy. The median (interquartile range) VO2 peak at baseline was 18.2 (15.4-19.9) mL/kg/min, and after exercise was 19.9 (17.1-21.1; P=0.048). Median AT at baseline was 12.2 (10.5-14.9), and 14.4 (12.3-15.4) after exercise (P=0.023). Time of exercise tolerated also improved from a median of 379to 604sec (P=0.001). No significant changes were seen in VE/VO2, VE/VCO2, or the time at which AT was achieved.
Conclusion
This study shows that cardiopulmonary aerobic fitness improves after a period of supervised exercise in patients scheduled for AAA repair. This is justification for a randomized trial to assess whether this affects morbidity and mortality after AAA repair.
Citation
Barakat, H. M., Shahin, Y., Barnes, R., Gohil, R., Souroullas, P., Khan, J., McCollum, P. T., & Chetter, I. C. (2014). Supervised exercise program improves aerobic fitness in patients awaiting abdominal aortic aneurysm repair. Annals of vascular surgery, 28(1), 74-79. https://doi.org/10.1016/j.avsg.2013.09.001
Journal Article Type | Article |
---|---|
Acceptance Date | Sep 6, 2013 |
Online Publication Date | Dec 11, 2013 |
Publication Date | 2014-01 |
Journal | Annals of Vascular Surgery |
Print ISSN | 0890-5096 |
Publisher | Elsevier |
Peer Reviewed | Peer Reviewed |
Volume | 28 |
Issue | 1 |
Pages | 74-79 |
DOI | https://doi.org/10.1016/j.avsg.2013.09.001 |
Keywords | Surgery; Cardiology and Cardiovascular Medicine; General Medicine |
Public URL | https://hull-repository.worktribe.com/output/432568 |
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