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Athletes with mild or moderate AR, but with LVEnd-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: 844
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