Schreurs Bibi A, Hopman Maria T E, Bakker Chantal M, Duijnhouwer Anthonie L, van Royen Niels, Thompson Paul D, van Kimmenade Roland R J, Eijsvogels Thijs M H
Department of Medical BioSciences Radboud University Medical Center Nijmegen The Netherlands.
Department of Cardiology Radboud University Medical Center Nijmegen The Netherlands.
J Am Heart Assoc. 2024 Feb 6;13(3):e031850. doi: 10.1161/JAHA.123.031850. Epub 2024 Jan 31.
The potential impact of exercise on valvular function and aortic diameters in patients with a bicuspid aortic valve remains unclear. Therefore, we assessed the association between lifelong exercise characteristics, valvular dysfunction, and aortic dilatation in patients with a bicuspid aortic valve.
In this cross-sectional study, exercise volume (metabolic equivalent of task minutes per week), exercise intensity, and sport type were determined from the age of 12 years to participation using a validated questionnaire. Echocardiography was used to assess aortic stenosis or aortic regurgitation and to measure diameters at the sinuses of Valsalva and ascending aorta. Aortic dilatation was defined as a -score ≥2. Four hundred and seven patients (42±17 years, 60% men) were included, of which 133 were sedentary (<500 metabolic equivalent of task minutes per week), 94 active (500-1000 metabolic equivalent of task minutes per week), and 180 highly active (≥1000 metabolic equivalent of task minutes per week). Moderate-to-severe aortic stenosis or aortic regurgitation was present in 23.7% and 20.0%, respectively. Sinuses of Valsalva and ascending aorta diameters were 34.8±6.6 and 36.5±8.1 mm, whereas aortic dilatation was found in 21.6% and 53.4%, respectively. Exercise volume was not associated with valve dysfunction or aortic dilatation. Vigorous intensity and mixed sports were associated with a lower prevalence of aortic stenosis (adjusted odds ratios, 0.43 [0.20-0.94] and adjusted odds ratios, 0.47 [0.23-0.95]). Exercise intensity and sport type were not associated with aortic regurgitation and aortic dilatation.
We found no deleterious associations between lifelong exercise characteristics, valvular dysfunction, and aortic dilatation in patients with a bicuspid aortic valve. Vigorous intensity and exercise in mixed sports were associated with a lower prevalence of moderate-to-severe aortic stenosis. These observations suggest that lifelong exercise does not appear to induce adverse cardiovascular effects in patients with a bicuspid aortic valve.
运动对二叶式主动脉瓣患者瓣膜功能和主动脉直径的潜在影响尚不清楚。因此，我们评估了二叶式主动脉瓣患者终身运动特征、瓣膜功能障碍和主动脉扩张之间的关联。
在这项横断面研究中，使用经过验证的问卷从12岁起至参与研究时确定运动总量（每周代谢当量任务分钟数）、运动强度和运动类型。采用超声心动图评估主动脉狭窄或主动脉反流，并测量主动脉窦和升主动脉的直径。主动脉扩张定义为z评分≥2。纳入407例患者（42±17岁，60%为男性），其中133例久坐不动（每周<500代谢当量任务分钟），94例活跃（每周500 - 1000代谢当量任务分钟），180例高度活跃（每周≥1000代谢当量任务分钟）。中度至重度主动脉狭窄或主动脉反流分别占23.7%和20.0%。主动脉窦和升主动脉直径分别为34.8±6.6和36.5±8.1mm，而主动脉扩张分别占21.6%和53.4%。运动总量与瓣膜功能障碍或主动脉扩张无关。剧烈运动强度和混合运动与主动脉狭窄患病率较低相关（调整后的比值比分别为0.43[0.20 - 0.94]和0.47[0.23 - 0.95]）。运动强度和运动类型与主动脉反流和主动脉扩张无关。
我们发现二叶式主动脉瓣患者的终身运动特征、瓣膜功能障碍和主动脉扩张之间不存在有害关联。剧烈运动强度和混合运动与中度至重度主动脉狭窄患病率较低相关。这些观察结果表明，终身运动似乎不会在二叶式主动脉瓣患者中诱发不良心血管效应。
