Exercise and sports participation in patients with thoracic aortic disease: a review.
Level 4 - case-series / case-control
Systematic review limited to observational studies, case reports, and animal models with no controlled human trials
PubMed 30887852 · doi:10.1080/14779072.2019.1585807
What was done
A systematic review was conducted across Medline, Embase, and Web of Science to evaluate the risks and benefits of exercise and sports participation in patients with thoracic aortic disease (including thoracic aortic aneurysm, dissection, Marfan syndrome, Loeys-Dietz syndrome, Turner syndrome, Ehlers-Danlos syndrome, and bicuspid aortic valve). Two independent reviewers screened 1,652 identified records.
What was found
A total of 26 studies and 12 case reports were included, covering aortic dimensions in athletes, exercise-related acute aortic dissections, and exercise in bicuspid aortic valve and Marfan syndrome. The abstract provides no quantitative effect estimates. The authors noted that exercise-induced blood pressure elevation may relate to acute dissection risk, but found zero controlled trials longitudinally evaluating the effect of exercise on dissection risk or survival in humans.
Why it matters
It highlights that existing clinical recommendations advising patients with thoracic aortic disease to avoid strenuous exercise rely on mechanistic hypotheses and anecdotal data rather than controlled clinical evidence.
Limits
The review identified no prospective longitudinal controlled trials in humans. Available evidence is confined to retrospective observational series, individual case reports, athlete cross-sectional measurements, and preclinical mouse models.
Cited by
- supports Individuals with genetic aortic conditions such as Marfan syndrome have an elevated risk of aortic dissection during strenuous exercise.