Athletes with mild or moderate AR, but with LV

End-diastolic size that is normal or only mildly

Increased, consistent with that which may result

Solely from athletic training (12), can participate in

All competitive sports. In selected instances, athletes

With AR and moderate LV enlargement (60 to 65

Mm) can engage in low and moderate static and low,

Moderate, and high dynamic competitive sports

(classes IA, IB, 1C, IIA, IIB, and IIC) if exercise

Tolerance testing to at least the level of activity

Achieved in competition demonstrates no symptoms

Or ventricular arrhythmias. Those with asymptomatic

Nonsustained ventricular tachycardia at rest or with

Exertion should participate in low-intensity competitive

sports only (class IA) (see also Task Force 7:

Arrhythmias).

Athletes with severe AR and LV diastolic diameter

Greater than 65 mm as well as those with mild or

Moderate AR and symptoms (regardless of LV dimension)

Should not participate in any competitive

Sports.

Those with AR and significant dilation of the proximal

Ascending aorta (greater than 45 mm) can engage

Only in low-intensity competitive sports (class

IA). These criteria do not apply to athletes with

Marfan syndrome and AR, in whom the risks of

Aortic dissection and rupture are high, and any degree

Of aortic dilatation would be sufficient to prohibit

competitive athletics, as discussed in Task Force 4:

HCM and Other Cardiomyopathies, Mitral Valve

Prolapse, Myocarditis, and Marfan Syndrome.

1337 JACC Vol. 45, No. 8, 2005 Bonow et al.

April 19, 2005:1334–40 Task Force 3: Valvular Heart Disease

BICUSPID AORTIC VALVES

WITH AORTIC ROOT DILATATION

There is growing awareness that many patients with

bicuspid aortic valves have disorders of vascular connective

tissue, involving loss of elastic tissue, that may result

in aortic root dilatation even in the absence of hemodynamically

significant AS or AR (17,18). These patients

have a risk of aortic dissection; surgery to repair the aorta

has been recommended for those patients with greatly

enlarged aortic roots (5,18). Recommendations for athletic

participation in patients with bicuspid valve disease

and associated aortic root dilatation are based on limited

data, but with the understanding that aortic dissection

can occur in some patients with aortic root diameters less

than 50 mm. The recommendations that follow are for

patients with bicuspid valves and associated aortic root

enlargement. If such patients also have significant AS or

AR, these recommendations should be considered in

concert with those discussed in the present Task Force

for patients with AS or AR. The following recommendations

do not pertain to patients with Marfan syndrome,

which are discussed in Task Force 4.

Recommendations:

Patients with bicuspid aortic valves with no aortic

Root dilatation (less than 40 mm or the equivalent

According to body surface area in children and adolescents)

And no significant AS or AR may participate

In all competitive sports.

Patients with bicuspid aortic valves and dilated aortic

Date: 2016-03-03; view: 709