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September 8, 2026European Heart Journal - Case ReportsOpen Access

Continued endurance training linked to stable aneurysm size and acceptable wall stress over 6 years.

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Population

1 75-year-old male endurance athlete with an ascending thoracic aortic aneurysm measuring 52 mm, a bicuspid…

Design

Case_report

Follow-up

6 years

Key result

Continued intensive endurance training in a 75-year-old male with a 52 mm ascending thoracic aortic aneurysm resulted in stable aneurysm size and wall stress below rupture thresholds over 6 years.

Authors

JSJuliana SenftingerMSMichael StiefelRMRobert Manka

Discussion

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Overview

May permit monitored endurance training in select older athletes with aneurysms; leaves open whether wall stress improves risk stratification over diameter.

Key Points

  • To evaluate the safety of continued high-intensity endurance exercise in an older athlete with a large ascending thoracic aortic aneurysm through biomechanical assessment beyond simple diameter measurements.
  • Clinical evaluation and longitudinal monitoring of a 75-year-old male endurance athlete with a 52 mm ascending thoracic aortic aneurysm, bicuspid aortic valve, and moderate aortic regurgitation who declined surgery.
  • Implementation of shared decision-making permitting continued endurance training under predefined blood pressure and heart rate thresholds alongside regular imaging surveillance over 6 years.
  • Application of Laplace's law to calculate circumferential aortic wall stress at rest and during exercise using serial aortic wall thickness and diameter measurements.
  • Over 6 years of follow-up, the ascending thoracic aortic aneurysm remained stable at 52 mm with a constant aortic wall thickness of 2.5 mm.
  • Calculated circumferential aortic wall stress remained below estimated rupture thresholds both at rest and during exercise conditions.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
A 75-year-old male endurance athlete with a 52 mm ascending thoracic aortic aneurysm, bicuspid aortic valve, and moderate aortic regurgitation, followed for 6 years.
E
Exposure
Continued endurance training under predefined blood pressure and heart rate limits, with regular imaging surveillance.
O
Outcome
Aneurysm size stability, aortic wall thickness, and calculated circumferential aortic wall stress.surrogate

This case suggests that exercise counselling for patients with ATAA should incorporate aortic wall thickness and wall stress assessments alongside aneurysm diameter.

Cite This Study

Senftinger et al. (2026) conducted a case report in Ascending thoracic aortic aneurysm (ATAA) (n=1). Continued intensive exercise under predefined blood pressure and heart rate limits with regular imaging surveillance was evaluated on Aneurysm size stability and aortic wall stress. Continued intensive endurance training in a 75-year-old male with a 52 mm ascending thoracic aortic aneurysm resulted in stable aneurysm size and wall stress below rupture thresholds over 6 years.

synapsesocial.com/papers/6a9fd82f58e84d0ff5b477ddhttps://doi.org/10.1093/ehjcr/ytag672
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Aortic dilation in masters endurance athletes: prevalence and associations with cardiac physiology and training load2026
  2. 2Acute effects of aerobic exercise on aortic wall stress in thoracic aortic disease2025 · 1 citations
  3. 3Ascending Aortic Aneurysms: From Pathophysiology to Surgical Repair2025 · 3 citations
  4. 4Sex‐Based Differences in Long‐Term Outcomes of Patients With Ascending Aortic Dilation2025 · 4 citations
  5. 5Endovascular Management of Asymptomatic Large Descending Thoracic Aortic Aneurysm After Coarctation of Aorta Repair: A Case Report2025