Sports Behavior in Middle-Aged Individuals with Anomalous Coronary Artery from the Opposite Sinus of Valsalva

Abstract

Objectives: Recommendations regarding sports restriction are lacking for middle-aged athletes with anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS). Methods: Sixty-three patients with ACAOS were subdivided into ACAOS with (n = 38) or without (n = 25) an interarterial course (IAC). Sports behavior, either competitive (COMP) or recreational (REC), was evaluated at the time of diagnosis and after a median follow-up of 4.2 years. Results: Mean age was 56 ± 11 years and 48 (76.2%) patients were engaged in sports. Three individuals (4.8%) were surgically corrected after diagnosis. Thirty-eight (60.3%) patients were aware of their diagnosis at follow-up and 12 (19.0%) were counseled by their physician about sports restrictions. Sports behavior at the time of diagnosis and at follow-up did not differ significantly, neither in patients engaged in COMP (17.5 vs. 12.7%, p = 0.619) nor those engaged in REC (58.7 vs. 61.9%, p = 0.856). Sport-related symptoms were not significantly different between ACAOS patients with and without IAC. No athlete had died at follow-up. Conclusions: The majority of middle-aged individuals with ACAOS were involved in sports activities at the time of diagnosis and at follow-up. Awareness and counseling about ACAOS diagnosis had no significant effect on sports behavior. IAC did not have an impact on sport-related symptoms, and outcomes were favorable in all athletes, regardless of surgical correction.

Anomalous Origin Of The Right Coronary Artery With Interarterial Course: Red Flag Or Innocent Bystander?

“…Furthermore, there is evidence that a large proportion of middle-aged individuals with newly diagnosed ACAOS by CCTA are involved in sports activities before diagnosis as well as at follow-up, regardless of whether they were surgically corrected or not, with a low rate of adverse cardiac events at follow-up. [29] Further considerations should be highlighted regarding our results:1) the mean age of our population is considerably higher when compared to the reported in autopsy studies; 2) most SCD cases associated with ACAOS occur in young patients performing high intensity physical activity, which contrasts with our population of asymptomatic patients in which right ACAOS with IAC was mainly an incidental nding. However, a recent study by Finocchiaro et al, [30] reports that SCD associated with right ACAOS with IAC occurred often at rest or during sleep.…”

Sport resumption and quality of life after surgical correction of anomalous origin of a coronary artery from the opposite sinus

“…Recent data have suggested that cardiopulmonary exercise test has an increased sensitivity for the detection of myocardial ischaemia ( 31 ). Finally, stress MRI has become an increasingly interesting and suitable modality for the detection of myocardial ischaemia in both children and adult patients with ACAOS ( 32 , 33 ). In our practice, we did not use a systemic cardiopulmonary exercise test and stress MRI for ACAOS evaluation, but considering these recent studies, we prefer to use these 2 modalities to detect inducible myocardial ischaemia in our future patients with ACAOS and for cardiac follow-up.…”

Diagnosis and Management of Anomalous Coronary Arteries with a Malignant Course

“…This was not the case in patients engaged in competitive sports (17.5% versus 12.7%, p=0.62) nor those engaged in recreational sports (58.7% versus 61.9%, p=0.86). [21] The IAC of the anomalous vessel did not have an impact either on sport-related symptoms, and outcomes were favorable in all athletes irrespective of surgical correction. [21] This emphasises that middle-aged or older people with newly detected ACAOS do not automatically need to restrict sports activity and should be assessed differently compared with younger people.…”