A Specialized Center for Clinically Oriented Research (SCCOR) P50 Program was funded at Stanford in 2004 to identify novel biomarkers of small Abdominal Aortic Aneurysm (AAA) disease and test the ability of exercise therapy to modify disease progression (termed AAA Simple Treatment or Prevention [AAA STOP]). Dr. Myers was the principal investigator for the training and exercise assessment component of the grant.
The study was based on evidence linking sedentary existence and resulting pro-inflammatory aortic conditions to the pathogenesis of AAA disease. The goal was to test the ability of regular exercise to reduce AAA risk, limit small aneurysm progression, and modify biologic markers of the disease.
The study has several components. First, 1,400 small AAA patients completed exercise history and health history questionnaires, and had a blood draw and abdominal ultrasound to correlate risk factors with AAA disease status. Second, 1,000 patients with previously defined exercise capacity underwent aortic imaging to correlate fitness status and exercise capacity with aortic diameter. Finally, 340 patients with small AAAs were randomized to exercise or usual activity, and followed over three years with serial imaging to test the ability of exercise therapy to modify disease progression.
The project has closed and analysis shows our training techniques to be highly effective even in this complicated patient group of atherosclerotic vasculopaths.
Myers J, Niebauer J. Exercise in Abdominal Aortic Aneurysms. In Pressler A, Niebauer J: Sports and Exercise Cardiology. New York: Springer Publishers, 2019.
Myers J, Dalman R, Hill, B. Exercise, vascular health, and abdominal aortic aneurysm disease. Clinical Exercise Physiology Reviews 1: 1-8, 2012.
Myers J, White J, Narasimhan B, Dalman R, on behalf of the AAA SCCOR investigators. Effects of exercise training in patients with abdominal aortic aneurysm: Preliminary results from a randomized trial. J Cardiopulm Rehabil Prev 30: 374-383, 2010.
Myers J, Powell A, Smith K, Fonda H, Dalman R. Cardiopulmonary exercise testing in abdominal aortic aneurysm: Profile, safety, and mortality estimates. Eur J Cardiovasc Prev Rehabil 18:459-466, 2011.
Myers J, McElrath M, Jaffe A, Smith A, Fonda H, Vu A, Hill, B, Dalman R. A randomized trial of exercise training in abdominal aortic aneurysm disease: The AAA STOP Trial. Med Sci Sports Exerc 46:2-9, 2014.
Bianchi VE, Herbert WG, Myers J, Ribisl PM, Dalman RL. Relationship of obstructive sleep apnea and cardiometabolic risk factors in elderly patients with abdominal aortic aneurysms. Sleep and Breathing 19: 593-598, 2015.
McElrath M, Fonda H, Chan K, Myers J. Exercise adherence in the elderly: Experience with Abdominal Aortic Aneurysm: Simple Treatment and Prevention (AAA STOP). J Vasc Nurs 35:12-20, 2017.
Lima RM, Vainshelboim B, Dalman R, Chan K, Ganantra R, Myers J. Exercise training improves ventilatory efficiency in patients with small abdominal aortic aneurysm: a randomized controlled study. J Cardiopulm Rehabil Prev 38: 239-245, 2018.
Niebauer S, Niebauer J, Dalman R, Myers J. Effects of exercise training on vascular markers of disease progression in patients with small abdominal aortic aneurysms. Am J Med 134:535-541, 2021.