Physical activity and sedentary behavior patterns in individuals with a bicuspid aortic valve compared to healthy controls

Abstract

Abstract Background A bicuspid aortic valve (BAV) is the most common congenital heart disease and associated with a higher lifetime risk of cardiovascular morbidity and mortality. Management of cardiovascular risk factors, including habitual physical (in)activity, is therefore key. However, little is known about physical activity (PA) and sedentary behavior (SB) patterns in individuals with BAV compared to healthy controls while there is debate how PA may influence BAV related cardiovascular complications. Purpose To compare objectively measured PA and SB characteristics between individuals with BAV and healthy age- and sex-matched controls. Methods Adults with BAV from our outpatient clinic were approached to participate and matched with age and sex- matched controls from the general population. SB, moderate-to-vigorous PA (MVPA) and step count were objectively assessed for 24 h/day during 8 consecutive days using an accelerometer (activPAL3 micro®) attached to the subject’s thigh. Transthoracic echocardiograms of the BAV participants were used to determine the presence of valvular dysfunction and to measure aortic diameters. Aortic dilatation was defined as >40 mm at the sinus of Valsalva or in the ascending aorta, whereas valvular dysfunction was defined as moderate-to-severe aortic stenosis or regurgitation according to current ESC guidelines. Results We recruited 100 BAV individuals (45±16 years old; 59% male), of which n=12 had valve dysfunction, n=22 had aortic dilatation and n=20 had a combination of valve dysfunction and aortic dilatation. We also included 100 healthy age- and sex-matched controls. SB was comparable between the BAV and control group (9.3 [8.5-10.2] vs 9.3 [8.2-10.2] hrs/day, p=0.84), whereas time spent in MVPA (72 [59-89] vs 98 [75-116] min/day, p <0.001) and daily step count (4,826 [4,004-5,801] vs 6,252 [4,784-7,484] steps/day, p<0.001) were markedly lower in individuals with BAV (Figure 1). Furthermore, no significant differences in SB, MVPA or step-count were found across BAV disease severity subgroups (Figure 2). Conclusion Individuals with BAV are less physically active compared to age- and sex-matched healthy controls. These differences were independent of disease severity, indicating that the lower activity patterns were not due to functional or disease-related limitations.Figure 1.Figure 2.