MEDICAL AREA 

Medicina dello Sport 2011 September;64(3):257-68

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English, Italian

Characteristics of the bicuspid aortic valve in non top-level athletes: a retrospective review of 16 years

Poletti G., Piolanti S., Cellini M.

Unit of Sports Medicine, Local Health Unit, Casalecchio di Reno, Bologna, Italy

Aim. A retrospective analysis of non top-level athletes (N.=19883) undergoing examination for physical fitness for competitive sports was conducted to identify cases of bicuspid aortic valve (BAV).
Methods. In the 16-year period (January 1, 1995 to March 31, 2011), 50 cases of BAV were diagnosed on transthoracic echocardiography (TTE) (N.=5601) performed at the Sports Medicine Center, Bologna (Casalecchio) Local Health Board.
Results. The prevalence of BAV was 0.89% (50/5601). The average age of the study population was 19.74±11.62 years; BAV was diagnosed in males in 78% of cases. Almost 50% of BAV cases were “uncomplicated”; there was a more frequent association between BAV and aortic insufficiency. The natural course of BAV in the young is toward aortic insufficiency rather than aortic stenosis, which is the natural course of BAV in adults, and the most common complication described in the literature. This apparent age-related change may be correlated with the particularly low age of our sample compared to that of other studies. Aortic root dilatation was second only to aortic valve insufficiency, whereas dilatation of the ascending aorta was extremely rare.
Conclusion. The study shows that the prognosis of BAV in young athletes is good despite the assumption that, since it is a disease of the aortic wall, progression of the disease will inevitably require valve or ascending aorta replacement. The findings highlight the importance of TTE in the diagnosis and monitoring of this congenital heart disease. This screening method should be offered at least once during a competitive athlete’s sports career.