Physical Stress Echocardiography Evaluation in Athletes with Bicuspid Aortic Valves

Objective: Bicuspid Aortic Valve (BAV) is normally asymptomatic for a long time in both the general population and regularlytrained athletes. The study aimed to evaluate the role of physical stress echocardiography in early identification of any possible dissimilarities in the Left Ventricle (LV) performance and the valve functioning of asymptomatic BAV athletes as compared to the Tricuspid Aortic Valve (TAV) athletes. Design: Data were collected for BAV and TAV athletes from echocardographic examinations to evaluate any possible differences between them. Setting: Sport Medicine Center University of FlorenceItaly. Participants: 66 male BAV athletes and 45 TAV athletes Assessment of risk factors: decrease in LV performance and aortic valve dysfunction during stress test. Main outcome measures: Measure of the standard echocardiographic parameters. Comparison of LV Ejection Fraction (EF) and Aortic Peak Flow Velocity (APFV) data in the two groups at rest and after stress. Results: At rest, values were normal in both groups, although LV systolic diameters tended to be higher in BAV. After physical effort, APFV and EF showed a significant increase in both groups, and for the former the values were at the upper limits in BAV (2.55 m/s BAV 2.12 m/s TAV). Conclusions: The data confirm normal LV performance in asymptomatic BAV athletes. Considering the tendency of this group to show slight enhancement of both APFV and LV dimensions in this group periodical evaluation with physical stress echography might be proposed as a followup procedure for early detection of any additional effect of physical exercise.