Competitive Sports Participation in Athletes with Thoracic Aortic Aneurysms and Dissections

Objectives

Individuals with thoracic aortic disease (TAD) are frequently counseled to avoid intensive exercise. We surveyed athletes with TAD to assess their athletic participation and cardiovascular symptoms or outcomes related to competitive sporting events.

Methods

Participants were eligible for this study if they had a diagnosis of TAD and had participated in at least one competitive athletic event. Data was collected via customized REDCap surveys. The primary study outcomes were competitive event participation and event-related symptoms, comparing the five years before and after aortic diagnosis.

Results

Anonymous surveys were sent to a total of 8,300 participants in two social media groups. Eighty-six eligible participants completed surveys: 37 with aneurysms, 33 with dissections, and 16 with both diagnoses. After diagnosis, competitive sports participation decreased from a mean of 7 events per year (10% of cohort) to a mean of 0.8 events per year (1.2% of cohort, P<0.05). Seven respondents experienced event-related health symptoms, primarily related to running or endurance events. One participant was hospitalized after competition for arrhythmia. No acute dissections or aortic interventions occurred. Weekly exercise time was greater in those without event-related symptoms. In multivariate analyses, the number of cardiovascular medications was associated with event-related symptoms.

Conclusion

Athletic competition decreased significantly after TAD diagnosis. In a selected cohort of highly active individuals with TAD, competition did lead to frequent symptomatic episodes but did not result in acute aortic events. These observations reinforce the importance of regular exercise to prevent symptomatic cardiovascular events for TAD patients who persist in competition.

Lay Summary

This study explored how people with thoracic aortic disease (TAD) who regularly competed in sports changed their participation after diagnosis and whether athletic events triggered any heart- or vessel-related problems.

• Key Finding 1: Competitive sports participation dropped sharply after diagnosis.

• Key Finding 2: While some participants experienced symptoms such as shortness of breath or irregular heart rhythm during endurance events, no one suffered an acute aortic tear or required emergency aortic surgery.