An Overview of Sport Participation and Exercise Prescription in Mitral Valve Disease

Abstract

The incidence of heart valve disease (HVD) has been rising over the last few decades, mainly due to the increasing average age of the general population, and mitral valve (MV) disease is the second most prevalent HVD after calcific aortic stenosis, but MV disease is a heterogeneous group of different pathophysiological diseases. It is widely proven that regular physical activity reduces all-cause mortality rates, and exercise prescription is part of the medical recommendations for patients affected by cardiovascular diseases. However, changes in hemodynamic balance during physical exercise (including the increase in heart rate, preload, or afterload) could favor the progression of the MV disease and potentially trigger major cardiac events. In young patients with HVD, it is therefore important to define criteria for allowing competitive sport or exercise prescription, balancing the positive effects as well as the potential risks. This review focuses on mitral valve disease pathophysiology, diagnosis, risk stratification, exercise prescription, and competitive sport participation selection, and offers an overview of the principal mitral valve diseases with the aim of encouraging physicians to embody exercise in their daily practice when appropriate.

Progression of Non-Significant Mitral and Tricuspid Regurgitation after Surgical Aortic Valve Replacement for Aortic Regurgitation

“…On a final and more practical note, our study underscores the importance of guidelinedirected multi-modality evaluation and management of those preprocedural conditions shown to be associated with MR or TR deterioration post SAVR for AR, including atrial fibrillation, HF [28,29], and various aortopathies [30,31]. Moreover, it suggests that patients with mild-to-moderate (vs up-to-mild) MR or TR may, under certain circumstances, benefit from interventional treatment of these valvulopathies at the time of the AV surgery.…”

Role of Cardiovascular Imaging in Risk Assessment: Recent Advances, Gaps in Evidence, and Future Directions

“…Poor image quality, reduced patient cooperation, artifacts, improperly oriented views, under-or over-estimation of chamber size, and ventricular function are other limitations to consider. Indeed, LVEF could be misleading in the presence of coexisting conditions such as moderate to severe mitral regurgitation, which can lead to an overestimation of left ventricular function [51,52]. Several issues are also involved when using advanced parameters such as Global Longitudinal Strain.…”