{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:38:28Z","timestamp":1790073508685,"version":"4.0.1"},"reference-count":73,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T00:00:00Z","timestamp":1669075200000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,21]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Prescribed aerobic-based exercise training is a low-risk fundamental component of cardiac rehabilitation (CR). Secondary prevention therapeutic strategies following a spontaneous coronary artery dissection (SCAD) or aortic dissection (AD) should include CR. Current exercise guidance for post-dissection patients recommends fundamental training components including target heart rate zones are not warranted. Omitting fundamental elements from exercise prescriptions risks safety and makes it challenging for both clinicians and patients to understand and implement recommendations in real-world practice. We review the principles of exercise prescription for CR, focusing on translating guidelines and evidence from well-studied high-risk CR populations to support the recommendation that exercise testing and individualized exercise prescription are important for patients following a dissection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>When patients self-perceive exercise intensity there is a tendency to underestimate intensities within metabolic domains that should be strictly avoided during routine exercise training following a dissection. However, exercise testing associated with CR enrolment has gained support and has not been linked to adverse events in optimally medicated post-dissection patients. Graded heart rate and blood pressure responses recorded throughout exercise testing provide key information for developing an exercise prescription. An exercise prescription that is reflective of medical history, medications, and cardiorespiratory fitness optimizes patient safety and yields improvements in blood pressure control and cardiorespiratory fitness, among other benefits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This clinical practice and education article demonstrates how to develop and manage a CR exercise prescription for post-acute dissection patients that can be safe and effective for maintaining blood pressure control and improving cardiorespiratory fitness pre\u2013post CR.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjopen\/oeac075","type":"journal-article","created":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T18:09:48Z","timestamp":1669140588000},"source":"Crossref","is-referenced-by-count":20,"title":["Individualized exercise prescription and cardiac rehabilitation following a spontaneous coronary artery dissection or aortic dissection"],"prefix":"10.1093","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0576-3229","authenticated-orcid":false,"given":"Erik H","family":"Van Iterson","sequence":"first","affiliation":[{"name":"Section of Preventive Cardiology and Rehabilitation, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic , 9500 Euclid Ave., Desk JB-1, Cleveland, OH 44195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke J","family":"Laffin","sequence":"additional","affiliation":[{"name":"Section of Preventive Cardiology and Rehabilitation, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic , 9500 Euclid Ave., Desk JB-1, Cleveland, OH 44195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars G","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic , 9500 Euclid Ave., Desk J4-1, Cleveland, OH 44195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1190-1774","authenticated-orcid":false,"given":"Leslie","family":"Cho","sequence":"additional","affiliation":[{"name":"Section of Preventive Cardiology and Rehabilitation, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic , 9500 Euclid Ave., Desk JB-1, Cleveland, OH 44195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,11,22]]},"reference":[{"key":"2022121102064463500_oeac075-B1","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1177\/1358863X16632898","article-title":"Aortic dissection","volume":"21","author":"Salameh","year":"2016","journal-title":"Vasc Med"},{"key":"2022121102064463500_oeac075-B2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1053\/j.semvascsurg.2021.02.003","article-title":"Epidemiology of aortic dissection","volume":"34","author":"Sen","year":"2021","journal-title":"Semin Vasc Surg"},{"key":"2022121102064463500_oeac075-B3","doi-asserted-by":"crossref","first-page":"e266","DOI":"10.1161\/CIR.0b013e3181d47d48","article-title":"2010 ACCF\/AHA\/AATS\/ACR\/ASA\/SCA\/SCAI\/SIR\/STS\/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine","volume":"121","author":"Hiratzka","year":"2010","journal-title":"Circulation"},{"key":"2022121102064463500_oeac075-B4","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.jtcvs.2021.04.053","article-title":"2021 The American Association for Thoracic Surgery expert consensus document: surgical treatment of acute type A aortic dissection","volume":"162","author":"Malaisrie","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022121102064463500_oeac075-B5","doi-asserted-by":"crossref","first-page":"3353","DOI":"10.1093\/eurheartj\/ehy080","article-title":"European Society of Cardiology, acute cardiovascular care association, SCAD study group: a position paper on spontaneous coronary artery dissection","volume":"39","author":"Adlam","year":"2018","journal-title":"Eur Heart J"},{"key":"2022121102064463500_oeac075-B6","doi-asserted-by":"crossref","first-page":"e523","DOI":"10.1161\/CIR.0000000000000564","article-title":"Spontaneous coronary artery dissection: current state of the science: a scientific statement from the American Heart Association","volume":"137","author":"Hayes","year":"2018","journal-title":"Circulation"},{"key":"2022121102064463500_oeac075-B7","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1016\/j.jacc.2020.05.084","article-title":"Spontaneous coronary artery dissection: JACC state-of-the-art review","volume":"76","author":"Hayes","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2022121102064463500_oeac075-B8","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.cjca.2016.01.009","article-title":"The first dedicated cardiac rehabilitation program for patients with spontaneous coronary artery dissection: description and initial results","volume":"32","author":"Chou","year":"2016","journal-title":"Can J Cardiol"},{"key":"2022121102064463500_oeac075-B9","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1097\/HCR.0000000000000111","article-title":"Cardiac rehabilitation after spontaneous coronary artery dissection","volume":"35","author":"Silber","year":"2015","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"2022121102064463500_oeac075-B10","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1097\/HJR.0b013e32831fd6c8","article-title":"French Registry of cases of type I acute aortic dissection admitted to a cardiac rehabilitation center after surgery","volume":"16","author":"Corone","year":"2009","journal-title":"Eur J Cardiovasc Prev Rehabil"},{"key":"2022121102064463500_oeac075-B11","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/14017431.2016.1257149","article-title":"Exercise-based cardiac rehabilitation in surgically treated type-A aortic dissection patients","volume":"51","author":"Fuglsang","year":"2017","journal-title":"Scand Cardiovasc J"},{"key":"2022121102064463500_oeac075-B12","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1016\/j.amjcard.2016.02.034","article-title":"Usefulness of cardiac rehabilitation after spontaneous coronary artery dissection","volume":"117","author":"Krittanawong","year":"2016","journal-title":"Am J Cardiol"},{"key":"2022121102064463500_oeac075-B13","doi-asserted-by":"crossref","first-page":"3825","DOI":"10.1093\/eurheartj\/ehab307","article-title":"Physical activity and exercise in patients with spontaneous coronary artery dissection and fibromuscular dysplasia","volume":"42","author":"Tweet","year":"2021","journal-title":"Eur Heart J"},{"key":"2022121102064463500_oeac075-B14","doi-asserted-by":"crossref","first-page":"623","DOI":"10.3949\/ccjm.88a.20162","article-title":"Spontaneous coronary artery dissection: principles of management","volume":"88","author":"Pristera","year":"2021","journal-title":"Cleve Clin J Med"},{"key":"2022121102064463500_oeac075-B15","doi-asserted-by":"crossref","first-page":"642739","DOI":"10.3389\/fcvm.2021.642739","article-title":"Physical activity and exercise patterns after spontaneous coronary artery dissection: insights from a large multinational registry","volume":"8","author":"Chacin-Suarez","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"2022121102064463500_oeac075-B16","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1177\/2047487320936782","article-title":"Beyond randomised studies: recommendations for cardiac rehabilitation following repair of thoracic aortic aneurysm or dissection","volume":"28","author":"Schwaab","year":"2021","journal-title":"Eur J Prev Cardiol"},{"key":"2022121102064463500_oeac075-B17","doi-asserted-by":"crossref","first-page":"1000001","DOI":"10.2340\/20030711-1000001","article-title":"Safety and outcomes of cardiac rehabilitation for patients with spontaneous coronary artery dissection","volume":"1","author":"Imran","year":"2018","journal-title":"J Rehabil Med Clin Commun"},{"key":"2022121102064463500_oeac075-B18","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1177\/2047487320913379","article-title":"Secondary prevention through comprehensive cardiovascular rehabilitation: from knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology","volume":"28","author":"Ambrosetti","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2022121102064463500_oeac075-B19","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1093\/eurjpc\/zwab007","article-title":"Exercise intensity assessment and prescription in cardiovascular rehabilitation and beyond: why and how: a position statement from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology","volume":"29","author":"Hansen","year":"2022","journal-title":"Eur J Prev Cardiol"},{"key":"2022121102064463500_oeac075-B20","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.jacc.2018.12.072","article-title":"Impact of exercise rehabilitation on exercise capacity and quality-of-life in heart failure: individual participant meta-analysis","volume":"73","author":"Taylor","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2022121102064463500_oeac075-B21","first-page":"CD001800","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease","volume":"11","author":"Dibben","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"2022121102064463500_oeac075-B22","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1001\/jama.2009.454","article-title":"Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial","volume":"301","author":"O\u2019Connor","year":"2009","journal-title":"JAMA"},{"key":"2022121102064463500_oeac075-B23","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/HCR.0000000000000337","article-title":"Progression of exercise training in early outpatient cardiac rehabilitation: AN OFFICIAL STATEMENT FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION","volume":"38","author":"Squires","year":"2018","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"2022121102064463500_oeac075-B24","doi-asserted-by":"crossref","first-page":"e024533","DOI":"10.1161\/JAHA.121.024533","article-title":"Demographic and regional trends of mortality in patients with aortic dissection in the United States, 1999 to 2019","volume":"11","author":"Nazir","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"2022121102064463500_oeac075-B25","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1001\/jamacardio.2021.4690","article-title":"Prevalence and disease Spectrum of extracoronary arterial abnormalities in spontaneous coronary artery dissection","volume":"7","author":"Persu","year":"2022","journal-title":"JAMA Cardiol"},{"key":"2022121102064463500_oeac075-B26","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1093\/eurheartj\/ehz048","article-title":"Spontaneous coronary artery dissection: no longer a rare disease","volume":"40","author":"Adlam","year":"2019","journal-title":"Eur Heart J"},{"key":"2022121102064463500_oeac075-B27","doi-asserted-by":"crossref","first-page":"e004689","DOI":"10.1161\/CIRCOUTCOMES.118.004689","article-title":"Population-based assessment of the incidence of aortic dissection, intramural hematoma, and penetrating ulcer, and its associated mortality from 1995 to 2015","volume":"11","author":"DeMartino","year":"2018","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2022121102064463500_oeac075-B28","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1093\/eurheartj\/ehz007","article-title":"Canadian spontaneous coronary artery dissection cohort study: in-hospital and 30-day outcomes","volume":"40","author":"Saw","year":"2019","journal-title":"Eur Heart J"},{"key":"2022121102064463500_oeac075-B29","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.amjcard.2022.01.046","article-title":"Spontaneous coronary artery dissection and evidence-based medicine","volume":"171","author":"Baechler","year":"2022","journal-title":"Am J Cardiol"},{"key":"2022121102064463500_oeac075-B30","doi-asserted-by":"crossref","first-page":"e140","DOI":"10.1161\/CIRCULATIONAHA.113.005819","article-title":"Cardiology patient page. Activity recommendations for postaortic dissection patients","volume":"130","author":"Chaddha","year":"2014","journal-title":"Circulation"},{"key":"2022121102064463500_oeac075-B31","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1002\/clc.23537","article-title":"Prognostic value of aerobic capacity and exercise oxygen pulse in postaortic dissection patients","volume":"44","author":"Delsart","year":"2021","journal-title":"Clin Cardiol"},{"key":"2022121102064463500_oeac075-B32","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.ijcard.2016.06.026","article-title":"Post aortic dissection: gap between activity recommendation and real life patients aerobic capacities","volume":"219","author":"Delsart","year":"2016","journal-title":"Int J Cardiol"},{"key":"2022121102064463500_oeac075-B33","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1097\/HCR.0000000000000446","article-title":"Cardiopulmonary exercise testing following open repair for a proximal thoracic aortic aneurysm or dissection","volume":"40","author":"Hornsby","year":"2020","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"2022121102064463500_oeac075-B34","doi-asserted-by":"crossref","DOI":"10.1053\/j.semtcvs.2021.05.017","article-title":"Cardiorespiratory fitness after open repair for acute type A aortic dissection \u2013 a prospective study","volume":"34","author":"Norton","year":"2022","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"2022121102064463500_oeac075-B35","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1161\/CIRCINTERVENTIONS.114.001760","article-title":"Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes","volume":"7","author":"Saw","year":"2014","journal-title":"Circ Cardiovasc Interv"},{"key":"2022121102064463500_oeac075-B36","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1016\/j.jacc.2017.06.053","article-title":"Spontaneous coronary artery dissection: clinical outcomes and risk of recurrence","volume":"70","author":"Saw","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2022121102064463500_oeac075-B37","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.ijcard.2015.10.213","article-title":"Sedentary behavior and predicted 10-yr risk for a first atherosclerotic cardiovascular disease (ASCVD) event using the pooled cohort risk equations among US adults","volume":"203","author":"Loprinzi","year":"2016","journal-title":"Int J Cardiol"},{"key":"2022121102064463500_oeac075-B38","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s10654-018-0380-1","article-title":"Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis","volume":"33","author":"Patterson","year":"2018","journal-title":"Eur J Epidemiol"},{"key":"2022121102064463500_oeac075-B39","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1161\/CIRCULATIONAHA.112.123117","article-title":"Cardiovascular risk of high- versus moderate-intensity aerobic exercise in coronary heart disease patients","volume":"126","author":"Rognmo","year":"2012","journal-title":"Circulation"},{"key":"2022121102064463500_oeac075-B40","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.amjcard.2014.11.040","article-title":"Safety of early enrollment into outpatient cardiac rehabilitation after open heart surgery","volume":"115","author":"Pack","year":"2015","journal-title":"Am J Cardiol"},{"key":"2022121102064463500_oeac075-B41","first-page":"CD012264","article-title":"Exercise-based cardiac rehabilitation in heart transplant recipients","volume":"4","author":"Anderson","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2022121102064463500_oeac075-B42","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1001\/jamacardio.2022.1651","article-title":"Effectiveness and safety of early initiation of poststernotomy cardiac rehabilitation exercise training: the SCAR randomized clinical trial","volume":"7","author":"Ennis","year":"2022","journal-title":"JAMA Cardiol"},{"key":"2022121102064463500_oeac075-B43","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1001\/jamacardio.2022.1410","article-title":"Endurance exercise following ascending thoracic aortic aneurysm resection in bicuspid aortic valve aortopathy","volume":"7","author":"Lai","year":"2022","journal-title":"JAMA Cardiol"},{"key":"2022121102064463500_oeac075-B44","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1097\/00008483-199907000-00006","article-title":"Non-physician supervision of cardiopulmonary exercise testing in chronic heart failure: safety and results of a preliminary investigation","volume":"19","author":"Squires","year":"1999","journal-title":"J Cardiopulm Rehabil"},{"key":"2022121102064463500_oeac075-B45","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1161\/CIRCULATIONAHA.112.110460","article-title":"The safety of cardiopulmonary exercise testing in a population with high-risk cardiovascular diseases","volume":"126","author":"Skalski","year":"2012","journal-title":"Circulation"},{"key":"2022121102064463500_oeac075-B46","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.1016\/j.jacc.2018.01.004","article-title":"2018 ACC\/AHA clinical performance and quality measures for cardiac rehabilitation: a report of the American College of Cardiology\/American Heart Association Task Force on performance measures","volume":"71","author":"Thomas","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2022121102064463500_oeac075-B47","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1093\/eurjpc\/zwaa141","article-title":"Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Cardiology (EAPC) and the ESC Council on Hypertension","volume":"29","author":"Hanssen","year":"2022","journal-title":"Eur J Prev Cardiol"},{"key":"2022121102064463500_oeac075-B48","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1097\/01.HCR.0000320068.35728.12","article-title":"Long-term disease management of patients with coronary disease by cardiac rehabilitation program staff","volume":"28","author":"Squires","year":"2008","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"2022121102064463500_oeac075-B49","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.ahj.2011.07.017","article-title":"Efficacy of exercise-based cardiac rehabilitation post-myocardial infarction: a systematic review and meta-analysis of randomized controlled trials","volume":"162","author":"Lawler","year":"2011","journal-title":"Am Heart J"},{"key":"2022121102064463500_oeac075-B50","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1001\/jamacardio.2021.2735","article-title":"Effect of exercise training on ambulatory blood pressure among patients with resistant hypertension: a randomized clinical trial","volume":"6","author":"Lopes","year":"2021","journal-title":"JAMA Cardiol"},{"key":"2022121102064463500_oeac075-B51","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1161\/CIRCULATIONAHA.121.055329","article-title":"Effects of lifestyle modification on patients with resistant hypertension: results of the TRIUMPH randomized clinical trial","volume":"144","author":"Blumenthal","year":"2021","journal-title":"Circulation"},{"key":"2022121102064463500_oeac075-B52","doi-asserted-by":"crossref","first-page":"e000895","DOI":"10.1136\/bmjsem-2020-000895","article-title":"Do the combined blood pressure effects of exercise and antihypertensive medications add up to the sum of their parts? A systematic meta-review","volume":"7","author":"Pescatello","year":"2021","journal-title":"BMJ Open Sport Exerc Med"},{"key":"2022121102064463500_oeac075-B53","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1161\/01.HYP.0000184225.05629.51","article-title":"Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors","volume":"46","author":"Cornelissen","year":"2005","journal-title":"Hypertension"},{"key":"2022121102064463500_oeac075-B54","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1097\/HJH.0000000000002619","article-title":"Exercise training reduces arterial stiffness in adults with hypertension: a systematic review and meta-analysis","volume":"39","author":"Lopes","year":"2021","journal-title":"J Hypertens"},{"key":"2022121102064463500_oeac075-B55","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1038\/s41569-020-00437-9","article-title":"Lifestyle interventions for the prevention and treatment of hypertension","volume":"18","author":"Valenzuela","year":"2021","journal-title":"Nat Rev Cardiol"},{"key":"2022121102064463500_oeac075-B56","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1097\/HJH.0b013e32835ca964","article-title":"Endurance exercise beneficially affects ambulatory blood pressure: a systematic review and meta-analysis","volume":"31","author":"Cornelissen","year":"2013","journal-title":"J Hypertens"},{"key":"2022121102064463500_oeac075-B57","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1097\/HJR.0b013e3282f48348","article-title":"Prognostic importance of weight loss in patients with coronary heart disease regardless of initial body mass index","volume":"15","author":"Sierra-Johnson","year":"2008","journal-title":"Eur J Cardiovasc Prev Rehabil"},{"key":"2022121102064463500_oeac075-B58","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.pcad.2018.07.014","article-title":"The effects of exercise and physical activity on weight loss and maintenance","volume":"61","author":"Swift","year":"2018","journal-title":"Prog Cardiovasc Dis"},{"key":"2022121102064463500_oeac075-B59","doi-asserted-by":"crossref","first-page":"2671","DOI":"10.1161\/CIRCULATIONAHA.108.834184","article-title":"High-calorie-expenditure exercise: a new approach to cardiac rehabilitation for overweight coronary patients","volume":"119","author":"Ades","year":"2009","journal-title":"Circulation"},{"key":"2022121102064463500_oeac075-B60","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/00008483-199707000-00007","article-title":"Validity of rating of perceived exertion during graded exercise testing in apparently healthy adults and cardiac patients","volume":"17","author":"Whaley","year":"1997","journal-title":"J Cardiopulm Rehabil"},{"key":"2022121102064463500_oeac075-B61","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1097\/00008483-200405000-00008","article-title":"Exercise prescription using resting heart rate plus 20 or perceived exertion in cardiac rehabilitation","volume":"24","author":"Joo","year":"2004","journal-title":"J Cardiopulm Rehabil"},{"key":"2022121102064463500_oeac075-B62","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1177\/1741826711398823","article-title":"Training prescription in patients on beta-blockers: percentage peak exercise methods or self-regulation?","volume":"19","author":"Zanettini","year":"2012","journal-title":"Eur J Prev Cardiol"},{"key":"2022121102064463500_oeac075-B63","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1097\/HCR.0000000000000682","article-title":"Comparison of ratings of perceived exertion and target heart rate-based exercise prescription in cardiac rehabilitation: a randomized controlled pilot study","volume":"42","author":"Shea","year":"2022","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"2022121102064463500_oeac075-B64","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/0002-9149(92)90673-M","article-title":"Physiologic responses to recumbent versus upright cycle ergometry, and implications for exercise prescription in patients with coronary artery disease","volume":"69","author":"Bonzheim","year":"1992","journal-title":"Am J Cardiol"},{"key":"2022121102064463500_oeac075-B65","first-page":"1558","article-title":"Optimizing the exercise protocol for cardiopulmonary assessment","volume":"55","author":"Buchfuhrer","year":"1983","journal-title":"J Appl Physiol Respir Environ Exerc Physiol"},{"key":"2022121102064463500_oeac075-B66","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1161\/CIR.0b013e31829b5b44","article-title":"Exercise standards for testing and training: a scientific statement from the American Heart Association","volume":"128","author":"Fletcher","year":"2013","journal-title":"Circulation"},{"key":"2022121102064463500_oeac075-B67","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1152\/japplphysiol.00598.2001","article-title":"Effects of body position on the ventilatory response following an impulse exercise in humans","volume":"92","author":"Haouzi","year":"2002","journal-title":"J Appl Physiol (1985)"},{"key":"2022121102064463500_oeac075-B68","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1001\/archinternmed.2009.312","article-title":"Role of lifestyle and aging on the longitudinal change in cardiorespiratory fitness","volume":"169","author":"Jackson","year":"2009","journal-title":"Arch Intern Med"},{"key":"2022121102064463500_oeac075-B69","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1161\/CIRCULATIONAHA.105.545459","article-title":"Accelerated longitudinal decline of aerobic capacity in healthy older adults","volume":"112","author":"Fleg","year":"2005","journal-title":"Circulation"},{"key":"2022121102064463500_oeac075-B70","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1161\/CIRCULATIONAHA.112.000483","article-title":"Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control: 10-year results from the Oxford Vascular Study","volume":"127","author":"Howard","year":"2013","journal-title":"Circulation"},{"key":"2022121102064463500_oeac075-B71","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1161\/CIRCULATIONAHA.112.105718","article-title":"Clinical features, management, and prognosis of spontaneous coronary artery dissection","volume":"126","author":"Tweet","year":"2012","journal-title":"Circulation"},{"key":"2022121102064463500_oeac075-B72","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1093\/ejcts\/ezw235","article-title":"The incidence and mortality of acute thoracic aortic dissection: results from a whole nation study","volume":"50","author":"Melvinsdottir","year":"2016","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022121102064463500_oeac075-B73","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1016\/j.amjcard.2017.05.037","article-title":"New generalized equation for predicting maximal oxygen uptake (from the fitness registry and the importance of exercise national database)","volume":"120","author":"Kokkinos","year":"2017","journal-title":"Am J Cardiol"}],"container-title":["European Heart Journal Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjopen\/advance-article-pdf\/doi\/10.1093\/ehjopen\/oeac075\/47198426\/oeac075.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/2\/6\/oeac075\/47774325\/oeac075.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/2\/6\/oeac075\/47774325\/oeac075.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T09:59:39Z","timestamp":1728467979000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjopen\/article\/doi\/10.1093\/ehjopen\/oeac075\/6840308"}},"subtitle":[],"editor":[{"given":"Magnus","family":"B\u00e4ck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,11,1]]},"references-count":73,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,11,21]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjopen\/oeac075","relation":{},"ISSN":["2752-4191"],"issn-type":[{"value":"2752-4191","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11,1]]},"published":{"date-parts":[[2022,11,1]]},"article-number":"oeac075"}}