Bicuspid aortic valve behaviour in elite athletes

• Published in: European heart journal cardiovascular imaging Vol. 20; no. 7; p. 772
• Main Authors: Boraita, Araceli, Morales-Acuna, Francisco, Marina-Breysse, Manuel, Heras, María-Eugenia, Canda, Alicia, Fuentes, María-Eugenia, Chacón, Antonio, Diaz-Gonzalez, Leonel, Rabadan, Manuel, Parra Laca, Begoña, Pérez de Isla, Leopoldo, Tuñón, José
• Format: Journal Article
• Language: English
• Published: England 01.07.2019
• Subjects: Aortic Diseases - diagnostic imaging; Aortic Diseases - epidemiology; Aortic Valve - abnormalities; Aortic Valve - diagnostic imaging; Athletes; Bicuspid Aortic Valve Disease; Echocardiography, Doppler; Female; Heart Valve Diseases - diagnostic imaging; Heart Valve Diseases - epidemiology; Humans; Male; Prevalence; Spain - epidemiology; Young Adult; Spain; Athletes heart; Echocardiography; Bicuspid aortic valve
• ISSN: 2047-2412
• DOI: 10.1093/ehjci/jez001

To determine the prevalence and characteristics of bicuspid aortic valve (BAV) among elite athletes and to analyse the effect of long-term exercise training on their aortas. Consecutive BAV and tricuspid aortic valve (TAV) elite athletes from a population of 5136 athletes evaluated at the Sports Medicine Center of the Spanish National Sports Council were identified using echocardiography. A total of 41 BAV elite athletes were matched with 41 TAV elite athletes, and 41 BAV non-athletic patients from three Spanish tertiary hospitals. Sixteen BAV elite athletes who had undergone at least two cardiac evaluations separated by more than 3 years were selected to assess their clinical course. The prevalence of BAV in elite athletes was 0.8%. The proximal ascending aorta was larger for both BAV groups in comparison to TAV athletes (P = 0.001). No differences in aortic diameters were found between BAV athletes and BAV non-athletes. In BAV elite athletes, the annual growth rates for aortic annulus, sinuses of Valsalva, sinotubular junction, and proximal ascending aorta were 0.04 ± 0.24, 0.11 ± 0.59, 0.14 ± 0.38, and 0.21 ± 0.44 mm/year, respectively. Aortic regurgitation was the only functional abnormality, but no significant progression was found. High-intensity training and sports competition may not aggravate BAV condition during elite athletes' careers. BAV elite athletes with mild-to-moderately dilated aortas may engage in high dynamic cardiovascular exercise without adverse consequences, although an echocardiographic follow-up is recommended.