Aortic Aneurysm, Abdominal Clinical Trial
Official title:
The AAA Get Fit Trial: A Pilot Randomised Controlled Trial of Community Based Exercise to Improve Fitness and Reduce Morbidity and Mortality of Patients With Abdominal Aortic Aneurysms
Rupture of abdominal aortic aneurysms(AAA) causes 12,000 deaths/year in the UK.1 Elective
repair to prevent this carries a perioperative mortality of 4.5% for open surgery and 1% for
endovascular repair. This risk is associated with poor cardiorespiratory fitness which can be
measured using Cardiopulmonary Exercise Testing(CPET) with the CPET variables, peak oxygen
uptake(peakVO2)<15ml/kg/min and anaerobic threshold(AT)<10.2ml/kg/min identifying patients at
increased risk of early death after AAA repair.3 These variables can therefore be used as
surrogate markers for cardiovascular fitness and risk of mortality and morbidity in AAA
surgery; optimising these markers should improve fitness and decrease this risk. The optimal
duration and type of exercise training for improving peak VO2 and AT in AAA patients is not
known. AAA patients are unique as they are motivated to reduce the risk of impending surgery
but are afforded the time to improve their fitness as repair may not be needed for months or
even years.
The investigators propose a pilot randomised controlled trial to explore the effectiveness of
a 20-week community (either home or gym-based) exercise programme to achieve sustained
improvements in peak VO2 and AT, as measured by CPET, in AAA patients. Changes in QoL,
habitual activity levels and cardiovascular risk will also be assessed. The results will
inform a definitive multicentre clinical trial on exercise to improve outcomes in elderly
patients with cardiovascular disease and AAA.
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