The Inter and Intra Reliability of Cardiopulmonary Exercise Testing in Abdominal Aortic Aneurysm Patients

Learn more about:
Related Clinical Trial
The PREHAAAB Trial: Multimodal Prehabilitation for Patients Awaiting Open Abdominal Aortic Aneurysm Repair EndoVascular Aortic Repair With Sac Embolization for the Prevention of Type II Endoleaks (the EVAR-SE Study) Global Iliac Branch Study Screening for Abdominal Aortic Aneurysms in the General Practice by Ultraportable Ultrasound Clinical Effectiveness of an Off-the-shelf Single REnal Scalloped sTent-graft for HOstile NEck Infrarenal Abdominal Aortic Aneurysm A Retrospective, Observational Study to Collect Clinical Safety and Performance Data of POLYMAILLE® EXTRA THIN Vascular Prothesis A Retrospective, Observational, Multicenter, Study to Collect Clinical Safety and Performance Data on POLYMAILLE®C Abdominal Aortic Aneurysm Screening Before Coronary Artery Bypass Surgery Sex-specific Differences in AAA Complexity EndurAnt Stent Graft System vs ExcluDer Endoprothesis: a Global, prospectiVe, rANdomized Clinical Trial in Sac rEgression (ADVANCE Study) Central Blood Pressure and Variability Evaluation Evaluation of the Impact of Prehabilitation on Recovery Following Open Surgery for Abdominal Aortic Aneurysm Low-dose Colchicine Inhibit Abdominal Aortic Aneurysm Growth Trial Elective Treatment Rates and Surgical Non-eligibility Among Men and Women With Intact Abdominal Aortic Aneurysms Anatomical and Perioperative Predisposing Factor for LIMb Occlusion of IncrafT Infrarenal Endograft Optimizing CO2 Injection Technique for EVAR A PROpensity Score Matching Analysis on ENDovascular vs Open Thoraco-Abdominal Aortic Aneurysm Repair (PRO-ENDO TAAA Study) ALTo endogrAft Italian Registry Sex-specific Differences in the Stress Response to Abdominal Aortic Aneurysm Repair AAA Rupture Risk Assessment in COVID-19 Pandemic Hellenic Registry of Ovation Alto™ Abdominal Stent Graft System Ultrasound Velocimetry in the Abdominal Aorta Before and After Endovascular Aneurysm Repair Real-World Data Collection of the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis When Used as a Bridging Stent With Branched and Fenestrated Endografts in the Treatment of Aortic Aneurysms Involving the Renal-Mesenteric Arteries Registry of Patients Treated by Preloaded Fenestrated Stent-graft Designs for Complex Endovascular Aortic Procedures (PLD.REG.) First In Human Study for Small to Medium-sized Abdominal Aortic Aneurysm (AAA) Retrospective Post-Market Clinical Follow-Up Study of GORE-TEX® Vascular Grafts and GORE® PROPATEN® Vascular Graft in Peripheral Artery Disease, Aortic Aneurysms, and Dialysis Access Assessment of the Endovascular Aortic Aneurysm Repair’s (EVAR) Main Body Lateral Movement Impact on the Rate of Reintervention After AAA’s Treatment ViTAA Registry Pre- and Post-Operative Monitoring for Endovascular Aortic Aneurysm Repair and Serial Monitoring for Abdominal Aortic Aneurysm Complementary and Alternative Medicine Interventions in Targeting Pain DOTATATE PETMRI AAA Study Abdominal Aortic Aneurysm Sac Healing and Prevention of Endoleaks – Netherlands An Innovative Approach to Automated Carbon Dioxide Angiography During Endovascular Abdominal Aortic Aneurysm Repair Impact of Intra- and Postoperative Continuous Infusion of Lidocaine on Analgesia in Vascular Anaesthesia Detecting Abdominal Aortic Aneurysms in First Degree Relatives (Adult Offsprings) to AAA Patients (DAAAD) Contrast Enhanced Ultrasound Endoleak Identification and Classification CCR2 AAA Pilot Study NIH CCR2 AAA Study Predicting Endoleaks Following Endovascular Aortic Aneurysm Repair Using 18F-Sodium Fluoride Comparative Study of a Software With the Gold Standard Limiting AAA With Metformin (LIMIT) Trial Deep Learning Applied to Plain Abdominal Radiographic Surveillance After Endovascular Aneurysm Repair (EVAR) of Abdominal Aortic Aneurysm (AAA) Carbon Dioxide Guided Angiography in Endovascular Abdominal Aortic Aneurysm Repair MuLtibranchEd Graft for OPen RepAir of ThoRacoabdominal Aneurysms Aneurysm Diameter and Surgical Outcome Evaluation of the Long Term Efficacy of Endovascular Treatment of Type 2 Endoleaks Point-of-care Ultrasound in Finland BNP and Vascular Surgery Understanding the Role of Autoimmune Disorders on the Initial Presentation of Cardiovascular Disease Heart Rate and Initial Presentation of Cardiovascular Diseases (Caliber) Social Deprivation and Initial Presentation of 12 Cardiovascular Diseases: a CALIBER Study The Effects of Anesthesia on Patients Undergoing Surgery for Repair of a Thoracoabdominal Aneurysm. The Role of Alcohol Consumption in the Aetiology of Different Cardiovascular Disease Phenotypes: a CALIBER Study Body Mass Index and Initial Presentations of Cardiovascular Diseases Totally Percutaneous Approach to Endovascular Treatment of Aortic Aneurysms (PEVAR-PRO) Haemostasis Management of Abdominal Aortic Procedures Overlay of 3D Scans on Live Fluoroscopy for Endovascular Procedures in the Hybrid OR Evaluation of the Safety and Efficacy of the Multilayer Stent Serum Uric Acid Levels and Onset of Cardiovascular Diseases: a CALIBER Study Ethnicity and Onset of Cardiovascular Disease: A CALIBER Study Fenestrated AAA Endovascular Graft Post-Approval Study Preconditioning Shields Against Vascular Events in Surgery Zenith Low Profile AAA Endovascular Graft (ZLP) Clinical Study Terumo Aortic Global Endovascular Registry A Study of Remote Ischaemic Preconditioning in Patients With Atherosclerosis Undergoing Vascular Surgery Preconditioning Shields Against Vascular Events in Surgery Risk Factors in the Initial Presentation of Specific Cardiovascular Disease Syndromes White Blood Cell Counts and Onset of Cardiovascular Diseases: a CALIBER Study Contrast-enhanced Ultrasound in Follow-up After Endovascular Aneurysm Repair Use of Fish Oil to Reduce Inflammation During Endovascular Abdominal Aortic Repair Contrast Enhanced Ultrasound, Endoleak Detection Following EVAR v1.3 Glycemic Control to Prevent Cardiac Morbidity in Vascular Surgery Performance and Safety of a Second Generation Antimicrobial Graft in Abdominal Position AneuFix – Prophylactic Sac Filling ANEUFIX for Endoleak Type II Repair Endurant Evo US Clinical Trial The Use of Carbon Dioxide as a Contrast Media for Performing Endovascular Procedures A Study of the Safety of Targeted AAA Screening Zenith® Low Profile AAA Endovascular Graft Zenith® Low Profile AAA Endovascular Graft Zenith(R) Low Profile AAA Endovascular Graft Clinical Study Hemodynamic Changes After Aortic Aneurysm Treatment With Stent-Graft Zenith® AAA Endovascular Graft Clinical Study Talent Converter Post-Approval Study Arterial Stiffness, Blood Pressure and Cardiac Output Study LIFE Study: Least Invasive Fast-Track EVAR DynaCT in Preoperative Imaging Before Insertion of Stentgraft TriVascular European Union (EU) Abdominal Stent Graft Trial Percutaneous Endovascular Aneurysm Repair (PEVAR) Trial Biomarkers of Aneurysm Wall Strength Post Implant Syndrome After EVAR and EVAS (INSPIRE Study) Control Post Endovascular Treatment of Aortic Aneurisms Through Magnetic Resonance and Ultrasound (SAFEVAR) Estimation of Biomechanical Aortic Wall Properties in Healthy and Aneurysmal Aortas Using Novel Imaging Techniques ANEUFIX for Endoleaks Type II TriVascular Canadian LIFE Study: Least Invasive Fast-Track EVAR (Endovascular Aneurysm Repair) Screening Cardiovascular Patients for Aortic aNeurysms (SCAN) Emergency Department Ultrasound in Renal Colic Endurant Evo International Clinical Trial Physician Modified Endovascular Grafts Talent Aortic Cuff Stent Graft System Compassionate Use Registry Fusion of CT Angiography With 3D Contrast Ultrasound as a Method for Follow up for Endovascular Aneurysm Repair Evaluation of a New Imagingtechnologie for Thrombosis The Effect of Surgery on Central Aortic Pressure & haEmodynamics Study Image Fusion of Preprocedural CTA With Real Time Fluoroscopy to Enhance EVAR Repair Post-operative CT Follow up After Nellix Endoprosthesis Implantation Endovascular Exclusion of TAAA/AAA Utilizing Fenestrated/Branched Stent Grafts Zenith® p-Branch™: Single-Center Study Observatory of Screening Aneurysms of the Abdominal Aorta During Echocardiography. National Epidemiological Survey Female Aneurysm Screening STudy The Pivotal Study of the Aptus Endovascular AAA Repair System Endovascular Treatment of Aorto-iliac Disease Using in Situ Fenestration Interest of a Post-operative Ultrasound With Systematic Use of Ultrasonic Contrast in the Follow-up of Aortic Endoprosthesis: Prospective Study at the University Hospital of Nice Zenith® Fenestrated Abdominal Aortic Aneurysm (AAA) Endovascular Graft Continued Access Study Endovascular Aneurysm Repair (EVAR) Gate Study Powerlink Bifurcated Stent Graft Long-Term Follow-up Study Screening Cardiovascular Patients for Aortic Aneurysms Zenith(R) Fenestrated Abdominal Aortic Aneurysm (AAA) Endovascular Graft Clinical Study Global Fenestrated Anaconda Clinical sTudy TriVascular Post-Market Registry Vasovist Endoleak Study AAA Registry: Clinical Outcomes of Highly Angulated anatomY Treated With the Aorfix™ Stent Graft Italian Multicenter Database for Open Conversions After EVAR Evaluation of the Endovascular Repair for Aortic Aneurysm (EVAR) Program at LHSC Preoperative Methylprednisolone in Endovascular Aortic Repair Prospective Aortic Biobank of POP-STAR E-tegra Stent Graft System in the Treatment of Infra-renal Abdominal Aortic Aneurysms EValuation of Systemic Atherothrombosis in Patients With ARTerial Disease of the Lower Limbs A Clinical Study to Evaluate the Safety and Performance of the Modular AAA Stent-Graft System Prospective Aneurysm Trial: High Angle Aorfix™ Bifurcated Stent Graft The Vascutek Custom Fenestrated Anaconda Post-Market Surveillance Study Advanced MRI in AAA Korean Registry of Percutaneous EVAR With INCRAFT Stent Graft for the Treatment of Abdominalaortic Aneurysm (K-INCRAFT) Safety and Efficacy of the SETA LATECBA Stent Graft for EVAR in Subjects With AAA UVA Brain and Aortic Aneurysm Study Acute Technical Outcomes of the Talent Abdominal Aortic Aneurysm (AAA) Stent-Graft Versus Cook Zenith Stent-Graft South American Abdominal Stent Graft Trial Zenith® Spiral-Z® AAA Iliac Leg Graft Post-market Registry AneuRx Post Market Study in the Treatment of AAA Predicting Aneurysm Growth and Rupture With Longitudinal Biomarkers The Boston Scientific ENOVUS Trial The (PIVOTAL) Study Suprarenal Proximal Cuff Study for Treatment of Abdominal Aortic Aneurysm Relation betwEen Abdominal Aorta and Carotid Artery Responses to SymPathetic stimulatiON uSing duplEx Ultrasound ARBITER-II: Aorfix™ Bifurcated Safety and Performance Trial: Phase II, Angulated Vessels Evaluation of Predictors of Aortic Aneurysm Growth and Rupture Compassionate Use of the Incraft® AAA Stent Graft System Aortic Distensibility Randomized Preventive Vascular Screening Trial of 65-74 Year Old Men in the Central Region of Denmark CRD007 for the Treatment of Abdominal Aorta Aneurysm (The AORTA Trial) ACT Guided Heparinization During Open Abdominal Aortic Aneurysm Repair. Cross-sectional Study of Prevalence Rate of Abdominal Aortic Aneurysm in OSAHS Patients From BTCH Mechanism and Prevention of Remote Organ Injury Following Ruptured Aortic Aneurysm Study of Abdominal Aortic Stent Grafts in the Treatment of Infrarenal Abdominal Aortic Aneurysms Study on Anti-inflammatory Effect of Anti-hypertensive Treatment in Patients With Small AAA’s and Mild Hypertension DynaCT Imaging in EVAR: Comparing Clinical Benefit of DynaCT to Multidetector CT as the Current Gold Standard. Zenith® LP Abdominal Aortic Aneurysm (AAA) Post-Market Registry Endovascular Exclusion of Thoracoabdominal and/or Paravisceral Abdominal Aortic Aneurysm Safety and Efficacy of Allogeneic MSCs in Promoting T-regulatory Cells in Patients With Small Abdominal Aortic Aneurysms Post-Market Study to Assess Outcomes of Patients Treated With AFX System Compared to Other EVAR Devices Dutch Randomised Endovascular Aneurysm Management (DREAM-) Trial Metformin Therapy in Non-diabetic AAA Patients Tonometry(1) and Duplex Ultrasound(2) to Predict CV Events in to be Treated Patients With an AAA Tonometry and Duplex Ultrasound to Predict AAA Progression and CV Events in Aneurysm Patients (1-2-3 Trial) Endoprosthesis Treatment Effects on Human Abdominal Aorta Aneurysms (AAA) Metabolic Activity Surviving Aneurysm Surgery: A Pilot Study on Exercise Training in Abdominal Aortic Aneurysm Patients Treovance Stent-Graft With Navitel Delivery System for Patients With Infrarenal Abdominal Aortic Aneurysms Cyclosporine A in Patients With Small Diameter Abdominal Aortic Aneurysms Intraoperative Assessment of Pulsatile Aneurysm Wall Motion During Endovascular Aneurysm Repair Curcumin to Prevent Complications After Elective Abdominal Aortic Aneurysm (AAA) Repair Post Implantation Syndrome and Administration on NSAIDs in Patients Undergoing EVAR for AAA LUCY Study: TriVascular Evaluation of Females Who Are Underrepresented Candidates for Abdominal Aortic Aneurysm Repair Elective Abdominal Aortic Aneurism – Open Versus Endovascular Repair TriVascular Evaluation of Females Who Are Underrepresented Candidates for Abdominal Aortic Aneurysm Repair in Europe Statin Use in Abdominal Aortic Aneurysm Repair GORE® EXCLUDER® Endoprosthesis French Mandatory Registry Endovascular Exclusion of Abdominal Aortic Aneurysms in High Risk Patients Aneurysma Hernia Study – Incidence of Incisional Hernias After Abdominal Aortic Aneurysm Repair Predictors of AAA Expansion and/or Rupture Non-invasive Monitoring of Endovascular Repair of Abdominal Aortic Aneurysm (VBA) Comparison of Beta-blocker Versus Angiotensin Receptor Blocker for Suppression of Aneurysm Expansion in Patients With Small Abdominal Aortic Aneurysm and Hypertension (BASE Trial) Preferences for Open Vs. Endovascular Repair for Abdominal Aortic Aneurysm Pharmacokinetics of CRD007 in Patients With Abdominal Aorta Aneurisms. Study of the Endovascular QUANTUM LP™ Stent Graft System in Abdominal Aortic Aneurysms (AAA) Immediate Management of the Patient With Rupture : Open Versus Endovascular Repair Study of the Glycocalyx in Abdominal Aortic Aneurysm Effect of Pre-operative Exercise in Abdominal Aortic Aneurysms (AAA) Patients. Validation of Fenestrations Positioning by Numerical Simulation Prevalence and Screening of Abdominal Aortic Aneurysms Among Men With Coronary Artery Disease START – Early Thrombocyte Administration to Patients With Ruptured Abdominal Aortic Aneurism Intraoperative Perfusion Patterns of the Sigmoid Colon During Elective Open Abdominal Aortic Aneurysm Repair The Inter and Intra Reliability of Cardiopulmonary Exercise Testing in Abdominal Aortic Aneurysm Patients Prevalence of Carotid Artery Stenosis and Abdominal Aortic Aneurysms in Brussels: a Population-based Screening Study. Screening of Abdominal Aortic Aneurysms Among Male Patients With TIA Symptoms The Nellix® EndoVascular Aneurysm Sealing System for the Treatment of Infrarenal Abdominal Aortic Aneurysms Screening of Abdominal Aortic Aneurysms Among Men With Coronary Artery Disease Cordis Bilateral AAA Device Compared to Open Surgical Repair of Abdominal Aortic Aneurysms (ARIBA) A Large Surgical Registry for Abdominal Aortic Aneurysms (AAA) Circulating microRNAs and Degenerative Abdominal Aorta Aneurysm Follow-up After Endovascular Repair of Abdominal Aortic Aneurysm Abdominal Aortic Aneurysms and Pseudoexfoliation Syndrome The Efficacy of Ticagrelor on Abdominal Aortic Aneurysm (AAA) Expansion Physician-Sponsored IDE for Talent Endoluminal Spring Graft System in Patients With Abdominal Aortic Aneurysms (AAA) Impact of Limb Remote Ischemic Preconditioning on Mortality and Quality of Life During Abdominal Aortic Aneurysm Repair Magnetic Resonance Elastography in Patients With Abdominal Aortic Aneurysms 34mm Cuff Study for Endovascular Repair of Abdominal Aortic Aneurysms Metformin for Abdominal Aortic Aneurysm Growth Inhibition Clinical Study of Abdominal Aortic Aneurysm Exclusion (TALENT Abdominal) A Phase I Evaluation of the Safety of the TriVascular Stent-Graft System in the Treatment of Abdominal Aortic Aneurysms Screening for Abdominal Aortic Aneurysm and Abdominal Aortic Atherosclerosis by Hand-Held Ultrasonography Clinical Study of the Treovance Stent-Graft for Patients With Abdominal Aortic Aneurysms Development of Novel Imaging Markers Predicting the Progression of Abdominal Aortic Aneurysm Using 3D Computed Tomography Structured Exercise Programme and Abdominal Aortic Aneurysm Surgery Study of the Effectiveness of Telmisartan in Slowing the Progression of Abdominal Aortic Aneurysms Evaluation of Effect of Angiotensin-converting Enzyme (ACE) Inhibitors on Small Aneurysm Growth Rate A Prospective Analysis on the Expansion Rates of Abdominal Aortic Aneurysms Reduction of Myocardial Infarction by Preconditioning in Patients With Ruptured Abdominal Aortic Aneurysm Magnetic Resonance Imaging To Predict Outcomes In Aortic Aneurysms Abdominal Aortic Aneurysm Sac Healing and Prevention of Endoleaks A MULTICENTER, OPEN LABEL, PROSPECTIVE, NON-RANDOMIZED STUDY OF INCRAFT™ IN SUBJECTS WITH ABDOMINAL AORTIC ANEURYSMS (INNOVATION) Abdominal Aortic Aneurysm Surgery and Thrombosis Ultra-sound for AAA Screening in Smoking Israeli Arab Men Prophylactic Mesh Implantation After Abdominal Aortic Aneurysm Repair Compassionate Use Treatment for a Single Patient With a Custom Made Branched/Fenestrated Endovascular Device for the Treatment of Complex Abdominal Aortic Aneurysm Comparison of Methods to Improve Abdominal Aortic Aneurysm (AAA) Screening Rates in the Primary Care Setting. Safety Study for the Treatment of Abdominal Aortic Aneurysms Prevention of Incisional Hernia After Elective Open Abdominal Aortic Aneurysm (AAA) Repair Sodium Fluoride Imaging of Abdominal Aortic Aneurysms Biomarker Profiling in Abdominal Aortic Aneurysm Patients Vascutek Anaconda™ Abdominal Aortic Aneurysm (AAA) Post-Market Surveillance Registry Limb Remote Ischemic Preconditioning Reduces Heart and Lung Injury After Abdominal Aortic Aneurysm Repair China Post-market Study of the INCRAFT® AAA Stent Graft System in Subjects With Abdominal Aortic Aneurysms (INITIATION) Screening for Thoracic Aortic Aneurysm Among a Cohort of Patients With a Degenerative Abdominal Aortic Aneurysm A Multicenter, Open Label, Prospective, Non-randomized Study of the InCraft® Stent Graft System in Subjects With Abdominal Aortic Aneurysms (INSPIRATION) Prevention of Endoleaks Using Autologous Platelet Gel on Unruptured Abdominal Aortic Aneurysms Screening for Abdominal Aortic Aneurysm in 65 Year Old Males in Oslo European (EU) Post Approval Study of the INCRAFT® AAA Stent Graft System in Subjects With Abdominal Aortic Aneurysms Prevention of Type II Endoleaks During Endovascular Treatment of Abdominal Aortic Aneurysm: Endovascular Treatment Versus Combination With Coil Embolisation of the Aneurysmal Sac HORIZON CE Pivotal Study to Treat Abdominal Aortic Aneurysm Screening Programme for Abdominal Aortic Aneurysm by Hand-Held-Ultrasonography in Primary Health Care ACZ885 for the Treatment of Abdominal Aortic Aneurysm Measurement of Maximum Diameter of Native Abdominal Aortic Aneurysm by Angio-CT Intact Abdominal Aortic Aneurysm Repair in Portugal The Altura Abdominal Aortic Aneurysm (AAA) Endograft Safety and Feasibility Study

Brief Title

The Inter and Intra Reliability of Cardiopulmonary Exercise Testing in Abdominal Aortic Aneurysm Patients

Official Title

The Inter and Intra Reliability of Cardiopulmonary Exercise Testing in Abdominal Aortic Aneurysm Patients

Brief Summary

      Exercise testing is commonly being used in patients before surgery to test their overall
      fitness. One group it is being used in is patients who have an enlarged blood vessel in their
      stomach. This is known as an abdominal aortic aneurysm. The exercise test used is known as a
      cardiopulmonary exercise test as it looks at both heart and lung function at the same time.
      Whilst this test is commonly used there have been no studies (to date) which have looked at
      how reliable this test is; this means how well the investigators can obtain the same (or very
      similar) results after multiple tests. The investigators would like to test this reliability
      both between patients and the clinicians performing the testing.

Detailed Description

      Background Research:

      The definition of an 'aneurysm' is permanent, localised dilatation of a blood vessel or heart
      chamber. The abdominal aorta is the largest blood vessel in the human body and usually has a
      diameter of 1.8 -2.0 centimetres (cm), dependant on age, sex and body habitus. Aortic
      dilatation is generally classed as an 'aneurysm' when dilation of the vessel is 1.5 times the
      normal size. An abdominal aortic aneurysm (AAA) affects any part of the aorta below the
      diaphragm with 80 % typically being found between the renal artery and aortic bifurcation.

      Risk Factors There are many factors that relate to the development of AAA. Gender is one of
      the biggest non-modifiable risk factors, as an AAA is four to six times more likely in males
      compared with females. Furthermore, the development of AAA in females occurs approximately
      ten years later than males. The risk of AAA also increases if there is family history of the
      disease, especially if the relative is first degree. There is also evidence to suggest there
      is an association between AAA and coronary heart disease. Hypertension has also been found to
      closely correlate with the development of AAA. Additionally, there is also a strong link
      between smoking and the likelihood of AAA development. Conversely, whilst the risk of AAA
      development in women is less than men, women have been shown to be more vulnerable to
      developing AAA than their male counterparts. The risk of AAA's also increases after the age
      of 65 years.

      If AAA are left undetected or untreated there is an increase in the likelihood of a rupture
      occurring. This causes critical internal bleeding and often results in death. Rupture of AAA
      is the cause of approximately 6000 deaths per year in the United Kingdom. Figures between
      1997- 2005 have shown a decrease in mortality but this is due to an earlier detection (of
      around five to ten years). The likelihood of rupture increases due to age, sex, smoking,
      hypertension and size and growth rate of the aneurysm. The size of the aneurysm is the
      strongest predictor of risk of rupture, smoking also contributes to an acceleration in
      expansion rate.

      Ultrasound Screening:

      Ultrasound screening is the preferred tool in identifying and monitoring the development of
      AAA as it is highly sensitive, cost effective and a non-invasive tool. The National Institute
      of Clinical Excellence (NICE) guidelines recommend that the National Health Service (NHS)
      offers ultra-sonographic screening to all males age 65 or over. The ultrasound scan enables
      the medical screener to determine the size of the abdominal aorta. According to the NICE
      (1.3) guidelines AAA are categorised by size, with a diameter of less than three cm being
      classified as normal with no follow up required. Patients who have an aneurysm diameter of
      between 3- 4.4 cm are re-scanned yearly, with those between 4.5 -5.4 cm being rescanned
      quarterly (every three months). AAA patients who have a diameter greater than 5.4 cm are
      referred to a vascular consultant for diagnosis and treatment. An AAA can be either true or
      false, with true aneurysms more commonly found. True aneurysms; involve three layers of the
      blood vessel walls Intima, Media and Adventitia, whereas false aneurysms are essentially a
      haematoma that forms outside the vessel wall.

      Surgical management of AAA:

      Following the diagnosis of a large AAA there are two possible medical surgical interventions,
      open or endovascular repair (EVAR).Open repair is considered to be a major surgical procedure
      and because of the possible complications preoperative assessment has to be carefully
      managed. There are three approaches whilst performing AAA laparotomy, transverse incision,
      longitude midline incision and retroperitoneal approach. The aortic segment is replaced by a
      prosthetic graft. After the operation patients are often monitored in intensive care unit
      (ICU) on average remain in hospital between seven to fourteen days. EVAR on the other hand is
      less invasive procedure, less painful and has a shorter stay in hospital and often does not
      require stay in ICU. EVAR gains access though the femoral artery and inserts a sent graft
      inside the abdominal aneurysm.

      Preoperative Risk Management:

      Surgeons base the decisions for operating on two major factors, firstly the risk of rupture,
      and secondly the diameter of the aneurysm and the growth rate. Before surgery the vascular
      consultant will subject the patient to a preoperative functional capacity assessment (FCA).
      The surgeons use FCA to establish if there are any potential operative and postoperative
      risks. Patients often have other comorbidities so the risk of operating may outweigh the
      potential benefits, therefore increasing the risk of premature mortality. The use of FCA has
      become an important screening tool in evaluating the fitness of AAA patients, serving as a
      good indictor to the risk of surgery and postoperative recovery. There are various ways to
      test FCA (step test, spirometry and cardiopulmonary exercise testing etc.) however, more
      recently cardiopulmonary exercise testing has been described as preferable tool in evaluating
      AAA patient's functional capacity.

      Cardio pulmonary exercise testing:

      It is widely accepted that a cardio-pulmonary exercise test (CPEX) is the 'gold standard' of
      FCA. Furthermore, CPEX is a non-invasive, cost effective and objective. It has been used for
      many years in elite sporting performance for research and screening and is now becoming
      increasingly utilised in clinical environments. CPEX testing allows clinicians to perform a
      controlled exercise test in a safe environment. It involves the measurement of a number of
      physiological parameters, as well as respiratory and cardiac monitoring.The basic underlying
      physiological principles underlying a CPEX is that it measures the efficiency and capacity of
      the oxygen-transport system; it also examines an individual's ability to exercise and the
      cardiovascular responses to variable levels of exertion. A CPEX provides breath by breath
      analysis and provides several important outcomes. These are; (1) VO2 MAX, (2) VeO2, (3)
      VECO2, (4)anaerobic threshold (AT), (5) respiratory exchange ratio, (6) time to AT and (7)
      total time tolerated are the variables that are obtained.

      Anaerobic threshold (AT):

      At the beginning of exercise, adenosine trisphosphate-creatine phosphate provides immediate
      energy required by the working muscles. As exercise continues cardiac output increases
      providing the working muscles with increased blood flow. As exercise levels rise, the
      workload of the muscles also rises requiring more blood flow and oxygen to be delivered. The
      oxygen demand is met by an increase cardiac output and lung ventilation. As the exercise
      continuous to become more strenuous, the muscle demand will begin to exceed the rate of
      oxygen delivery by the respiratory system. At this point the main fuel glucose is metabolised
      into lactic acid. This dissociates to lactate and hydrogen ions (H+) resulting in acidosis,
      which is the marker known as the Anaerobic Threshold (AT). The most common way of measuring
      the AT non-invasively is the V-slope method see figure 1.

      This can be explained via the following:

      As a participant begins incremental exercise their expired minute volume (VE) increases
      linearly with their oxygen consumption (VO2) and carbon dioxide consumption (VCO2). H+ are
      produced via anaerobic metabolism which is buffered by bicarbonate (HCO3-) and produces
      carbon dioxide (CO2). This is washed out in the lungs and is measured via the breath by
      breath analysis in the expired air. As VCO2 rises disproportionately to VO2, it allows the
      clinician to determine the AT; this is achieved by plotting VCO2 against VO2. Linear
      regression lines are drawn through the upper and lower curve and the point of intersection
      indicates where VCO2 increased disproportionately to VO2 and hence is estimated to be the AT.

      An individual's aerobic capacity is known as their VO2MAX. The most common way of measuring a
      person VO2 max is an incremental exercise test either performed on a motorized treadmill or
      cycle-ergometer, measured in millilitres per kilogram per minute ( The aerobic
      capacity can be affected by factors such as gender, genetics, body composition and age. A
      healthy 20-25 year old male has an average VO2 max of 42.5 - 46.4, whereas a
      healthy female of the same age has an average of 33 - 36.9 There is approximately
      ten percent drop with aerobic capacity every decade (dependent on fitness). For patients with
      AAA it is suggested that they should achieve and a threshold (AT) value above 10.2
      for open repair or above 8.2 for EVAR. They should also achieve a VO2MAX value above 15 Values lower than this can increase the risk of postoperative mortality (within 30

      Whilst there have been numerous studies into the importance of a CPEX, there have been no
      studies to date which have determined the Inter and Intra reliability of this test in the AAA


      The aim of this study is therefore to determine the Inter and Intra reliability of CPEX
      testing on both a cycle- ergometer and motorised treadmill in patients with abdominal aortic

Study Type


Primary Outcome

Anaerobic threshold

Secondary Outcome

 Minute ventilation


Abdominal Aortic Aneurysm



Study Arms / Comparison Groups

 Treadmill-Test operator A
Description:  Randomised to motorised treadmill group A for inter reliability, observer A will perform both exercise tests


* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information

Recruitment Status


Estimated Enrollment


Start Date

July 3, 2016

Completion Date

June 14, 2017

Primary Completion Date

March 31, 2017

Eligibility Criteria

        Inclusion Criteria:

          -  • Must be over the age of 45

               -  The patients must have the ability to walk unaided

               -  Must be considered for open or endovascular repair

               -  Have an AAA diameter of 5.4 cm or over.

               -  English speaking and able to follow simple protocol instructions

        Exclusion Criteria:

          -  • Active cancer treatment.

               -  Patients whom are not able to give informed consent

               -  Severe cardiovascular, musculo-skeletal or pulmonary illness precluding ability
                  to partake in CPEX testing.




45 Years - N/A

Accepts Healthy Volunteers



Amy E Harwood, MSc, , 

Location Countries

United Kingdom

Location Countries

United Kingdom

Administrative Informations



Organization ID


Responsible Party


Study Sponsor

Hull University Teaching Hospitals NHS Trust


 University of Hull

Study Sponsor

Amy E Harwood, MSc, Principal Investigator, AVSU Hull Royal Infirmary

Verification Date

June 2019