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Toy et al. Vessel Plus 2024;8:22 Vessel Plus
DOI: 10.20517/2574-1209.2023.149

Original Article Open Access

Multicenter randomized controlled trial of exercise in

aortic dissection survivors: rationale, design, and
initial hemodynamic data

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Yasmin A. Toy , Kayla N. House , Leslie M. Boyer , Jennifer L. McNamara , Marion A. Hofmann-Bowman ,
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Kim A. Eagle , Michelle S. Lim , Alan C. Braverman , Siddharth K. Prakash 1
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Department of Internal Medicine, John P. and Kathrine G. McGovern Medical School, University of Texas Health Science Center
at Houston, Houston, TX 77030, USA.
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John T. Milliken Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA.
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Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
Correspondence to: Dr. Siddharth K. Prakash, McGovern Medical School, University of Texas Health Science Center at Houston,
6431 Fannin Street, MSB 6.116, Houston, TX 77030, USA. E-mail: Siddharth.K.Prakash@uth.tmc.edu
How to cite this article: Toy YA, House KN, Boyer LM, McNamara JL, Hofmann-Bowman MA, Eagle KA, Lim MS, Braverman AC,
Prakash SK. Multicenter randomized controlled trial of exercise in aortic dissection survivors: rationale, design, and initial
hemodynamic data. Vessel Plus 2024;8:22. https://dx.doi.org/10.20517/2574-1209.2023.149
Received: 1 Dec 2023 First Decision: 25 Jan 2024 Revised: 8 Feb 2024 Accepted: 9 May 2024 Published: 16 May 2024
Academic Editors: Carlos A. Mestres, Cristiano Spadaccio Copy Editor: Fangling Lan Production Editor: Fangling Lan

Abstract
Aims: There are currently no evidence-based guidelines for exercise after thoracic aortic dissection (TAD), leading
to highly variable recommendations that frequently lead patients to restrict their physical activities. This
multicenter randomized controlled trial was intended to evaluate the safety and efficacy of a moderate intensity
guided exercise program for TAD survivors.

Methods: Participants were eligible if they had a Type A or Type B dissection at least 90 days before enrollment
and could attend two in-person study visits. The guided exercise circuit consisted of six aerobic, isotonic, or
isometric exercises that participants continued at home with virtual follow-up sessions. The primary endpoint is
the change in the composite anxiety and depression PROMIS-29 T-score at 12 months. Secondary endpoints
include changes in grip strength, weight, 24-h ambulatory blood pressure, and arterial biomechanical properties
measured by central arterial waveform analysis.

Results: Preliminary analysis of the first 81 enrolled participants demonstrated that the guided exercise circuit was
completed safely and was not associated with severe hypertension, injury, or adverse cardiovascular events. At
enrollment, adverse central waveform or ABPM characteristics were prevalent and were significantly associated
with exertional hypertension.

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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