Bailey, Tom G., Perissiou, Maria, Windsor, Mark, Schulze, Karl, Nam, Michael, Magee, Rebecca, Leicht, Anthony S., Green, Daniel J., Greaves, Kim, Golledge, Jonathan, and Askew, Christopher D. (2018) Effects of acute exercise on endothelial function in abdominal aortic aneurysm patients. American Journal of Physiology-Heart and Circulatory Physiology, 314 (1). H19-H30.

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Abstract

Endothelial dysfunction is observed in patients with abdominal aortic aneurysm (AAA), who have increased risk of cardiovascular events and mortality. This study aimed to assess the acute effects of moderate and higher-intensity exercise on endothelial function, as assessed by flow mediated-dilation (FMD), in AAA patients (n=22; 74±6 y) and healthy adults (n=22; 72±5y). Participants undertook three randomised visits, including moderate-intensity continuous exercise (40% peak power output, PPO), higher-intensity interval exercise (70% PPO), and a no-exercise control. Brachial artery FMD was assessed at baseline, 10- and 60-min after each condition. Baseline FMD was lower in AAA patients compared to healthy adults [by 1.10%, (95% CI, 0.72 to 1.81), P=0.044]. There were no group differences in the FMD responses after each condition(P=0.397). FMD did not change after the control condition, but increased by 1.21% (95% CI, 0.69 to 1.73, P<0.001) 10 min after moderate-intensity continuous exercise in both groups, and returned to baseline levels after 60-min. Conversely, FMD decreased by 0.93% (95% CI, 0.41 to 1.44, P<0.001) 10-min after higher-intensity interval exercise in both groups, and remained decreased after 60 min. This study found that the acute response of endothelial function to exercise is intensity-dependent and similar between AAA patients and healthy adults. This provides evidence that regular exercise may improve vascular function in AAA, as it does in healthy adults. Improved FMD following moderate-intensity exercise may provide short-term benefit. Whether the decrease in FMD following higher-intensity exercise represents additional risk and/or a greater stimulus for vascular adaptation remains to be elucidated.

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