Zeppilli Paolo, Bianco Massimiliano, Bria Serena, Palmieri Vincenzo
Centro Studi di Medicina dello Sport--Università Cattolica del Sacro Cuore, Rome, Italy.
J Cardiovasc Med (Hagerstown). 2006 Apr;7(4):282-7. doi: 10.2459/01.JCM.0000219322.04881.9e.
The bicuspid aortic valve is the most frequent congenital anomaly of the heart in adults. Since the 1970s, with the advent of two-dimensional echocardiography, the in-vivo diagnosis of bicuspid aortic valve has become easier and greater attention has been paid to this anomaly in normal young people, particularly in sportsmen because, from a theoretical point of view, physical exercise may stress the abnormal aortic valve, favouring an early deterioration of the valve itself, as well as a dilation of the ascending aorta. Although the bicuspid aortic valve may remain without clinical consequences for a lifetime, it may be responsible for severe complications such as aortic stenosis, aortic insufficiency, endocarditis and aortic dilation/dissection, sometimes requiring surgery. Moreover, the bicuspid aortic valve may be associated with other cardiovascular anomalies, mainly aortic coarctation. At present there are no prospective studies dealing with effect of physical training and competitive sports on the natural course of the bicuspid aortic valve. However, in order to take any decision about sports eligibility, sports physicians should perform an initial accurate staging of the bicuspid aortic valve, taking into account haemodynamic factors, aortic complications and associated significant cardiovascular anomalies. A strict follow-up, with serial cardiological controls, is mandatory as well as antibiotic prophylaxis for endocarditis, particularly in subjects engaged in contact sports.
二叶式主动脉瓣是成人中最常见的先天性心脏异常。自20世纪70年代以来，随着二维超声心动图的出现，二叶式主动脉瓣的活体诊断变得更加容易，并且在正常年轻人，尤其是运动员中，这种异常受到了更多关注。因为从理论上讲，体育锻炼可能会给异常的主动脉瓣带来压力，促使瓣膜本身过早退化，以及升主动脉扩张。尽管二叶式主动脉瓣可能终生无临床症状，但它可能导致严重并发症，如主动脉狭窄、主动脉瓣关闭不全、心内膜炎和主动脉扩张/夹层，有时需要进行手术。此外，二叶式主动脉瓣可能与其他心血管异常有关，主要是主动脉缩窄。目前尚无关于体育锻炼和竞技运动对二叶式主动脉瓣自然病程影响的前瞻性研究。然而，为了就运动资格做出任何决定，运动医生应在考虑血流动力学因素、主动脉并发症和相关重大心血管异常的情况下，对二叶式主动脉瓣进行初步准确分期。严格的随访，包括系列心脏检查，以及心内膜炎的抗生素预防是必需的，特别是对于从事接触性运动的受试者。
