Arterial Stiffness and Abdominal Aortic Aneurysm: The effect of acute exercise

Maria-Christina Perissiou

doi:10.25907/00164

Abdominal aortic aneurysm (AAA) is a localised dilatation of the abdominal aorta leading to an increase in normal diameter by >50%. AAA accounts for approximately 2% of all deaths worldwide (Upchurch and Schaub 2006). Surgical repair is the only current treatment option but only available for patients with large AAA (≥55mm) (Nordon, Hinchliffe et al. 2011) leaving patients with small AAA (≤55 mm) with no treatment options. Increased arterial stiffness is a key factor characterising the development and growth of an AAA (Raaz, Zollner et al. 2015) and likely contributes to elevated cardiovascular mortality in patients with small AAA (Golledge, Muller et al. 2006, Bath, Gokani et al. 2015). Therefore, arterial stiffness could be used as an important treatment target in order to delay aneurysm progression and reduce cardiovascular risk. Arterial stiffness is reduced with increased cardiorespiratory fitness (Gando, Murakami et al. 2016) and aerobic-exercise training in older adults (Fujie, Sato et al. 2014). These adaptations are attributed to the frequent, repetitive haemodynamic perturbations associated with each bout of exercise (Green, Hopman et al. 2017). A single bout of exercise transiently lowers arterial stiffness in healthy adults (Kingwell, Berry et al. 1997, Mutter, Cooke et al. 2017), is commonly accompanied by short-term improvements in arterial function and central blood pressure (Millen, Woodiwiss et al. 2016) and may be dependent on exercise intensity (Tordi, Mourot et al. 2010). However, in adults with cardiovascular comorbidities commonly observed in patients with AAA, excessive increases in arterial stiffness during and after exercise (Shim, Yang et al. 2011, Gkaliagkousi, Gavriilaki et al. 2014, Bunsawat, Ranadive et al. 2017) may transiently exacerbate cardiovascular risk (Schultz, La Gerche et al. 2017). To date, little is known about the haemodynamic effects of acute exercise in patients with AAA. Determining the arterial stiffness response to exercise would provide better understanding of the short-term risks and benefits of exercise in patents with AAA, and an insight into the potential efficacy of exercise for reducing arterial stiffness and cardiovascular risk. Hence, this thesis aimed to determine the effect of a single bout of exercise on the post-exercise arterial stiffness response between patients with AAA and healthy older adults. As patients with AAA are older and with low levels of cardiorespiratory fitness, this thesis also explored the effects of cardiorespiratory fitness and exercise intensity on post-exercise arterial stiffness, in healthy older adults. Additionally, this thesis aimed to establish the reliability of its measurements by assessing the reliability of post-exercise changes in arterial stiffness in older healthy adults.

Arterial Stiffness and Abdominal Aortic Aneurysm: The effect of acute exercise

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