Monda Emanuele, Verrillo Federica, Rubino Marta, Palmiero Giuseppe, Fusco Adelaide, Cirillo Annapaola, Caiazza Martina, Guarnaccia Natale, Mauriello Alfredo, Lioncino Michele, Perna Alessia, Diana Gaetano, D'Andrea Antonello, Bossone Eduardo, Calabrò Paolo, Limongelli Giuseppe
Inherited and Rare Cardiovascular Diseases Unit, Department of Traslational Medical Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, 80131 Naples, Italy.
Unit of Cardiology and Intensive Coronary Care, "Umberto I" Hospital, 84014 Nocera Inferiore, Italy.
Diagnostics (Basel). 2022 Jun 4;12(6):1392. doi: 10.3390/diagnostics12061392.
Thoracic aortic dilatation is a progressive condition that results from aging and many pathological conditions (i.e., connective tissue, inflammatory, shear stress disorders, severe valvular heart disease) that induce degenerative changes in the elastic properties, leading to the loss of elasticity and compliance of the aortic wall. Mild aortic root enlargement may be also observed in athletes and is considered as a normal adaptation to regular exercise training. On the other hand, high-intensity physical activity in individuals with a particular genetic substrate, such as those carrying gene variants associated with Marfan syndrome or other inherited aortopathies, can favor an excessive aortic enlargement and trigger an acute aortic dissection. The evaluation of the aortic valve and aortic root diameters, as well as the detection of a disease-causing mutation for inherited aortic disease, should be followed by a tailored decision about sport eligibility. In addition, the risk of aortic complications associated with sport in patients with genetic aortic disease is poorly characterized and is often difficult to stratify for each individual athlete. This review aims to describe the relationship between regular physical activity and aortic dilation, focusing on patients with bicuspid aortic valve and inherited aortic disease, and discuss the implications in terms of aortic disease progression and sport participation.
胸主动脉扩张是一种渐进性疾病，由衰老和许多病理状况（如结缔组织病、炎症性疾病、剪切应力紊乱、严重瓣膜性心脏病）引起，这些病理状况会导致弹性特性发生退行性变化，进而导致主动脉壁弹性和顺应性丧失。在运动员中也可能观察到轻度主动脉根部扩大，这被认为是对常规运动训练的正常适应。另一方面，对于具有特定遗传背景的个体，如携带与马凡综合征或其他遗传性主动脉疾病相关基因变异的个体，高强度体育活动可能会导致主动脉过度扩大并引发急性主动脉夹层。评估主动脉瓣和主动脉根部直径，以及检测遗传性主动脉疾病的致病突变后，应针对运动资格做出个性化决策。此外，遗传性主动脉疾病患者运动相关的主动脉并发症风险特征尚不明确，而且往往难以对每位运动员进行分层。本综述旨在描述规律体育活动与主动脉扩张之间的关系，重点关注二叶式主动脉瓣和遗传性主动脉疾病患者，并讨论其对主动脉疾病进展和运动参与的影响。
