Key result
The prevalence of premature ventricular beats during exercise testing in athletes with bicuspid aortic valve was 7.02%, which was not significantly different from athletes without BAV (6.25%, p > 0.05).
Why the study?
In competitive sports, eligibility for athletes with BAV can be barred by arrhythmias, but the prevalence of PVBs on exercise testing at first evaluation required verification.
Does the presence of a bicuspid aortic valve increase the prevalence of premature ventricular beats during exercise testing in athletes?
Cohort (n=756)
No
Does the presence of a bicuspid aortic valve increase the prevalence of premature ventricular beats during exercise testing in athletes?
Absolute Event Rate: 7.02% vs 6.25%
p-value: p=> 0.05
The prevalence of premature ventricular beats during exercise testing in athletes with bicuspid aortic valves is low and not significantly different from athletes without the condition.
Similar PVB prevalence during exercise in BAV athletes does not alter monitoring; leaves open arrhythmic risk in prospective cohorts.
Purpose: Bicuspid aortic valve (BAV) represents a common congenital cardiac disease (1–2%) normally compatible with sports activity. In the case of competitive sports, eligibility can be barred by the presence of symptoms, aortic valve dysfunction, or arrhythmias. This investigation of a large cohort of BAV athletes aims to verify the prevalence of premature ventricular beats (PVBs) found in the exercise test (ET) at the first sports medicine clinical evaluation. Methods: A sample of 356 BAV athletes, regularly examined over a period of 10 years at the Sports Medicine Center of the University of Florence, was retrospectively evaluated for arrhythmic events found in the first sports medicine check-up carried out. The athletes (321 M and 79 F), aged between 8–50 years (mean age 21.8 ± 11.6), practised sports at high dynamic cardiovascular intensity (mainly soccer, basketball, and athletics). Criteria for participation included a 2D echocardiography and ET conducted at 85% of maximal effort. Ventricular arrhythmic events were reported if found to be ≥3 at rest and/or during the exercise test and for subjects with any other cardiac or systemic structural diseases. Individuals aged >50 were excluded from the study. The selected participants were matched with a control group of 400 athletes with similar levels of training (age 20.0 ± 9.9) without BAV. Results: Only 25 (7.02%) of BAV athletes showed PVBs at the ET. A total of 403 single PVBs and four monomorphic couples were observed; a polymorphic pattern was present in only three athletes, and only five had exercise-induced PVBs at peak. None had acute events or major arrhythmias. The difference in PVBs prevalence in BAV athletes vs. controls (PVBs 6.25%) was not significant (p > 0.05). Conclusions: The prevalence of PVBs is low in BAV athletes and appears not to differ from athletes without BAV. Despite this, the behaviour of PVBs at the ET should be considered for the major suspicion for arrhythmic events. More data in this field could optimize the cost/effectiveness ratio for eventual ECG Holter indications.
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Donadei et al. (2019) conducted a cohort in Bicuspid aortic valve (BAV) (n=756). Bicuspid aortic valve (BAV) vs. Athletes without BAV was evaluated on Prevalence of premature ventricular beats (PVBs) at the exercise test (p=> 0.05). The prevalence of premature ventricular beats during exercise testing in athletes with bicuspid aortic valve was 7.02%, which was not significantly different from athletes without BAV (6.25%, p > 0.05).
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