Elite athletes with mitral or aortic regurgitation and their cardiopulmonary capability

C. Langer; T. Butz; K.-P. Mellwig; E. Oepangat; A. Fruend; L. Faber; D. Horstkotte; M. Wiemer; F. Van Buuren

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Document Details :

Title: Elite athletes with mitral or aortic regurgitation and their cardiopulmonary capability
Author(s): C. Langer , T. Butz , K.-P. Mellwig , E. Oepangat , A. Fruend , L. Faber , D. Horstkotte , M. Wiemer , F. Van Buuren
Journal: Acta Cardiologica
Volume: 68 Issue: 5 Date: 2013
Pages: 475-480
DOI: 10.2143/AC.68.5.2994470

Abstract :
Background: Aortic or mitral valvular regurgitation (left cardiac valvular regurgitation, LCVR) of less than second-degree (<°II) occasionally found in competitive athletes is of questionable relevance. Precisely detectable by echocardiography there is scarce published data that clarifies cardiopulmonary capacity or any limitations LCVR <°II may cause.
Methods: In this single-centre study we consecutively recruited highly trained athletes (n = 14) with LCVR <°II detected in 2D echo. Not included were athletes with multi- or right-cardiac valvular dysfunction and structural heart disease other than bicuspid aortic valve or mitral valve prolaps. Target parameters were determined by 2D echo and spiroergometry.
Results: There were no significant differences with regard to age and body mass index. Echocardiographically determined muscle mass index was increased in both groups (134 ± 14.7 vs 129.6 ± 27.5; P = 0.69), whereas the left-ventricular end-diastolic diameter index was significant higher in the LCVR <°II group (27.3 ± 1.3 vs 25.2 ± 2.4; P = 0.04). However, there were no significant differences with regard to (oxygen uptake) VO₂ at baseline (athletes with LCVR <°II 5.7 ± 0.9 vs controls 5 ± 0.96, P = 0.06), at the anaerobic threshold (athletes with LCVR <°II 47.3 ± 8.4 vs controls 47.4 ± 5, P = 0.97) and maximally (VO₂max; athletes with LCVR <°II 57.7 ± 6.3 vs controls 57.1 ± 5.1, P = 0.81). Neither levels of lactate nor of brain natriuretic peptide differed significantly.
Conclusion: High level athletes presenting with aortic or mitral regurgitation <°II in are not disadvantaged with regard to their cardiopulmonary capability.