News items Exercise Proven Safe for Large Group of Patients with Cardiovascular Disease

6 February 2024

Until now, many individuals with a bicuspid aortic valve were advised to exercise caution in sports activities, as it was thought to pose potential risks. A bicuspid aortic valve is the most common congenital heart defect affecting one to two out of every hundred individuals. Research conducted by Radboud university medical center, funded by the Heart Foundation and the Hartekind Foundation, now reveals that individuals with this condition can safely engage in sports activities. 

Researchers at Radboudumc surveyed over 400 individuals with a bicuspid aortic valve about their sports and exercise behaviors throughout their lives. They found no adverse correlation between exercising and aortic valve problems such as stenosis or leakage, or aortic dilatation. The type of sport, as well as the amount and intensity of physical activity, did not have any negative associations. Furthermore, the researchers observed that individuals engaging in high-intensity sports or activities such as soccer, hockey, or tennis may even have a lower incidence of aortic valve stenosis. 

Most Common Congenital Heart Defect 

One to two out of every hundred individuals are born with a bicuspid aortic valve, characterized by having only two valve leaflets instead of three. It is by far the most common congenital heart defect. A bicuspid aortic valve typically functions well, often being incidentally discovered during heart echocardiography. However, individuals diagnosed with this condition need regular check-ups due to an increased risk of heart problems such as aortic valve stenosis or leakage, or aortic dilatation. 

Exercise Caution Advised

Historically, individuals with this congenital heart defect were advised to be cautious with sports activities due to concerns about elevated blood pressure and increased blood flow during exercise potentially accelerating the deterioration of the heart valve and aorta. This was investigated in a study at Radboudumc, led by researcher Bibi Schreurs and cardiologist Roland van Kimmenade. Van Kimmenade stated, 'We surveyed all adult patients with a bicuspid aortic valve about their sports history from childhood to adulthood. Then, during their latest hospital check-up, we assessed the condition of their heart valve and aorta. We found no association between exercising and heart valve or aortic problems.'

Healthy Aging Perspective 

This reassuring message provides hope for the significant number of Dutch individuals with a bicuspid aortic valve. These individuals can, in principle, engage in physical activity and sports without undue concern. Schreurs added, 'An active lifestyle does not necessarily have negative effects on this heart defect. This also means that having a heart defect is not always a reason to feel like a patient. That's a reassuring message.'

Thanks to improved care and surgeries at a young age, the survival chances of children with congenital heart defects have significantly improved. However, this poses new challenges for the care of these patients, as they have an increased risk of heart or vascular diseases later in life, such as heart failure or arrhythmias. The Heart Foundation and Hartekind Foundation aim to ensure that individuals with congenital heart defects can also age healthily, thus financially supporting this research. 

About this publication

Dit artikel verscheen in Journal of the American Heart Association: Associations of Lifelong Exercise Characteristics With Valvular Function and Aortic Diameters in Patients With a Bicuspid Aortic Valve - Bibi A. Schreurs, Maria T. E. Hopman, Chantal M. Bakker, Anthonie L. Duijnhouwer, Niels van Royen, Paul D. Thompson, Roland R. J. van Kimmenade and Thijs M. H. Eijsvogels. DOI: 10.1161/JAHA.123.031850.

National Collaboration 

This research is part of the OUTREACH consortium, a large national research project aimed at earlier recognition and better treatment of the consequences of congenital heart defects. The goal is to enable more individuals with congenital heart defects to age healthily. Research on congenital heart defects is highly complex, which is why the OUTREACH consortium involves collaboration between all academic hospitals involved in the treatment of patients with congenital heart defects in the Netherlands, as well as various research institutes, including Erasmus MC, Amsterdam UMC, LUMC, UMCG, UMC Utrecht, Radboudumc, and the Hubrecht Institute. The Heart Foundation and Hartekind Foundation are jointly investing €3 million in this national research project.

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Pauline Dekhuijzen

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