Bicuspid Aortic Valve in Competitive Athletes

Laura Stefani ^1*, Giorgio Galanti ², Loira Toncelli ³, Paolo Manetti ⁴, Maria Concetta Vono ³, Marta Rizzo ³ and Nicola Maffulli ⁵

¹ Sport Mdicine Centre University Florence, Italy
² Sport Medicine Centre- University Florence, Italy
³ Sport Medicine Centre - University Florence, Italy
⁴ Sport Medicien Centre -University Florence, Italy
⁵ Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Stoke-on-Trent, United Kingdom

^* To whom correspondence should be addressed. E-mail: laura-stefani{at}tiscali.it.

Accepted 10 May 2007

Abstract

Aim: Bicuspid aortic valve (BAV) is a common congenital cardiac condition. The presence of BAV in non-élite athletes has been poorly investigated; it is usually asymptomatic until valvular stenosis, regurgitation or other vascular alterations are evident.

Design: Over a three-year period, 2273 competitive athletes were consecutively investigated with trans-thoracic echocardiography. The traditional parameters , the aortic root dimensions at four levels and the systolic and diastolic flow of aortic valve were studied with continuous Doppler according to the echo guidelines.

Setting: The study protocol included all the non-élite athletes investigated for the first evaluation to obtain eligibility.

Patients: 2273 competitive athletes aged 8 to 60 years from several sports and regularly trained were evaluated with anamnesis , clinical check-up and echocardiography in order to exclude subjects with systemic or congenital heart disease.

Results: We diagnosed BAV in 58 athletes (2.5%). Of these, 9 had normal valvular function, 47 had abnormal valvular function with mild-moderate aortic regurgitation, and 2 had moderate stenosis. Aortic root dimensions at all levels were significantly greater in athletes with BAV than in athletes with a normal tricuspid valve. No relationship was found with age, body surface area, aortic regurgitation, or years of training.

Conclusions: BAV is a relatively common congenital cardiac disease in athletes and commonly asymptomatic for a long time . We suggest the usefulness of evaluating young athletes using echocardiography at least once when they start their sporting activity

Key Words: athletes, bicuspid aortic valve, heart valve

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