Exercise recommendations for patients with Marfan syndrome: an updated review

Marfan syndrome (MFS) is a genetic connective tissue disorder which is inherited in an autosomal dominant manner. It is a multisystem disorder affecting the skeletal, ocular, pulmonary and cardiovascular systems. The cardiovascular complications such as aortic root dilatation and aortic dissection represent the most life-threatening of these and are the major causes of a reduced life-expectancy in Marfan patients compared to the general population. While exercise offers the general population several health benefits, particularly in reducing cardiovascular risks, in MFS it has long been considered a double-edged sword because of the condition's unique pathology and exercise related cardiovascular risks. How much exercise is beneficial and how much is detrimental? Questions regarding optimal intensity, frequency, duration and type of exercise are still difficult to answer due to a lack of outcome studies in this area. The current guidelines for MFS and exercise are based on limited research. This review aims to explore and summarise the current evidence-based exercise recommendations for patients with MFS, the types of exercise they can safely engage in, and the key precautions to follow.