Effects of sports activity in athletes with bicuspid aortic valve and mild aortic regurgitation

Galanti, Giorgio; Stefani, Laura; Toncelli, Loira; Vono, Maria Concetta Robertina; Mercuri, Roberto; Maffulli, Nicola

doi:10.1136/bjsm.2008.047407

Cited by 48 publications

(32 citation statements)

References 28 publications

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“…Aortic root was measured at the aortic valve annulus in 15 studies 7,[18][19][20][23][24][25]27,28,30,31,34,36,38,39 and at the sinuses of Valsalva in 12 studies. 7,[21][22][23][24]26,28,29,32,33,35,37 (Tables 1 and 2). In the 13 studies that directly compared athletes with controls, there were variations in the degree of matching; 11 studies matched for age, and 3 studies explicitly stated that they matched for body size.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…28 Yearly echocardiograms performed in 88 athletes with BAV for 5 years demonstrated that the proximal ascending aorta increased by 0.98 mm/y. 28 This rate of increases is comparable to that observed in nonathletes with BAV, which ranges among studies from ≈0.2 to 1.9 mm/y. 45 Nevertheless, additional studies focusing solely on aortic root dimension changes in athletes with BAV are needed to evaluate the effect of exercise training on this subgroup of athletes.…”

Section: Discussionmentioning

confidence: 99%

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A Meta-Analysis of Aortic Root Size in Elite Athletes

2013

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and atrium (Appendix I in the online-only Data Supplement). In addition, we manually reviewed the references of included studies Background-The aorta is exposed to hemodynamic stress during exercise, but whether or not the aorta is larger in athletes is not clear. We performed a systematic literature review and meta-analysis to examine whethere athletes demonstrate increased aortic root dimensions compared with nonathlete controls. Methods and Results-We searched MEDLINE and Scopus from inception through August 12, 2012, for Englishlanguage studies reporting the aortic root size in elite athletes. Two investigators independently extracted athlete and study characteristics. A multivariate linear mixed model was used to conduct meta-regression analyses. We identified 71 studies reporting aortic root dimensions in 8564 unique athletes, but only 23 of these studies met our criteria by reporting aortic root dimensions at the aortic valve annulus or sinus of Valsalva in elite athletes (n=5580). Athletes were compared directly with controls (n=727) in 13 studies. On meta-regression, the weighted mean aortic root diameter measured at the sinuses of Valsalva was 3.2 mm (P=0.02) larger in athletes than in the nonathletic controls, whereas aortic root size at the aortic valve annulus was 1.6 mm (P=0.04) greater in athletes than in controls. Conclusions-Elite athletes have a small but significantly larger aortic root diameter at the sinuses of Valsalva and aortic valve annulus, but this difference is minor and clinically insignificant. Clinicians evaluating athletes should know that marked aortic root dilatation likely represents a pathological process and not a physiological adaptation to exercise. .).The online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Meta-Analysis of Aortic Root Size in Elite Athletes

2013

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“…Outcomes data on ascending thoracic aortic aneurysms and exercise are also lacking. In the bicuspid aortic valve (BAV) population which is associated with progressive aortic enlargement, a study by Galanti et al 34 found that over a 5-year period, the rate of aortic growth for athletes was no different than for the sedentary, non-athletic BAV population. However, the genetics associated with BAV remains elusive and the pathogenesis may be very different from Marfan syndrome and related conditions.…”

Section: Lack Of Outcomes Datamentioning

confidence: 99%

Marfan syndrome, inherited aortopathies and exercise: What is the right answer?

Cheng

Owens

2016

Br J Sports Med

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Exercise recommendations for those who have Marfan syndrome or other genetic predisposition for thoracic aortic disease remain controversial and at times ambiguous. There are no outcomes studies to help guide recommendations. In this review, we examine the guidelines regarding exercise and inherited aortic conditions, the theoretical reasoning and circumstantial evidence that support the guidelines, as well as the knowledge gaps that continue to exist.

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“…It has been suggested in previous studies that these “normal” alterations have implications for mitral and tricuspid valve function if annular dilatation causes incomplete closure of the valve leaflets 12–14. A varying prevalence of valvular regurgitation has been reported in athletes 14–17…”

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confidence: 99%