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Exercise in Patients With Bicuspid Aortic Valve and Aortic Dilation
Danish Saleh1, Meilynn Shi2, S Chris Malaisrie2
1Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
The Annals of Thoracic Surgery
|July 17, 2025
Summary
Vigorous exercise did not accelerate aortic growth in patients with bicuspid aortic valve (BAV) and aortic dilation. This suggests current exercise restrictions for BAV patients may be overly cautious and could deter healthy behaviors.
Area of Science:
- Cardiology
- Aortic Diseases
- Exercise Physiology
Background:
- Vigorous exercise is generally discouraged for individuals with aortic dilation or aneurysm.
- Bicuspid aortic valve (BAV) is linked to aortic dilation, but acute aortic syndrome incidence is low.
- The study investigated exercise's impact on aortic growth in BAV patients with existing dilation.
Purpose of the Study:
- To determine if higher intensity and duration (I&D) exercise is associated with increased aortic growth in patients with BAV and aortic dilation.
- To evaluate the safety of exercise in this patient population.
Main Methods:
- A prospective cohort of BAV patients with aortic dilation was analyzed.
- Patients were categorized into higher I&D (>4 h/wk) and lower I&D (<4 h/wk) exercise groups.
- Aortic diameter changes were monitored over a median follow-up of 8.8 years.
Main Results:
- No significant differences in aortic diameter evolution were observed between higher and lower I&D exercise groups.
- Demographics, risk factors, and medication use were similar between groups.
- No cases of acute aortic syndrome occurred in either exercise group.
Conclusions:
- Higher I&D exercise was not associated with progressive aortic dilation in BAV patients with aortic dilation.
- Findings suggest a need to re-evaluate exercise restrictions for this population.
- Current restrictions may discourage beneficial cardiovascular activities.
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