Avatar universal

Valve regurgitation and long-distance running

I'm 28, 186 cm, 77 kg, max pulse 194, rest – 50 bpm. Got rheumatic heart disease in my childhood and now have fibrosis of the aortic valve with regurgitation (1-2), mitral valve prolapse with regurgitation (1-2) and tricuspid valve regurgitation (1).
1 year ago I gave up smoking and started endurance running. Since then I completed several 10k races and one half-marathon. My average weekly training plan includes 50k of running (5 days) with 80% done on pulse below 154-152 and only 20% done at pulse about 175-179 bpm. Also twice a week I try to do 40-minute workouts like planks, pushups and so on (with my bodyweight).
Last week I visited a doctor and here are the changes for the last year (before|after):
- Rest pulse (70 bpm|50 bpm)
- No changes in regurgitation status (aortic regurgitation LVOT 19%);
- Aorta diameter (34 mm|34 mm);
- Left ventricle (LV diastolic diameter 54mm|58mm, LV diastolic volume 142ml|167ml, LV systolic volume 39ml|57ml, Ejection fraction 72%|65%);
- Left Ventricular Mass (LV mass/BSA 93g/m2| 114 g/m2, Septal thickness 0.93 cm|1.0-1.1 cm, Posterior wall thickness 0.93 cm|1.0 cm);
- Left atrium size (35 mm| 32mm, 33/41 mm | 41/47 mm).
Since I started running, I lost about 8 kg, my blood pressure decreased from 140/90 to 130-125/70-65.
The doctor looked at the results and told me to limit physical activity (running), because it can lead to heart failure in future. Could he be over-cautious? Because it was just a cardiologist, not a sports cardiologist or physiotherapist. Could the changes in my LV be the result of the physiological, not the pathological change? Or it's the result of the cumulative effect of the aortic and mitral valve leakage? Next year I would like to finish my first marathon but now I don't know whether I should keep running. Could you express your opinion on this issue?
Thank you very much for the answer!
4 Responses
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1124887 tn?1313754891
Looks like you have an athletic heart with good pumping force and large chamber dimensions. Some doctors seem to use "one size fits all" regarding wall thickness. If the chambers are large, it's normal for the walls to be too. In Norway, left ventricular hypertrophy starts at >1,3 cm.

I would get a second opinion from a sports cardiologist.
Helpful - 0
11548417 tn?1506080564
I am a cyclist with mitral valve prolapse and moderate mitral regurgitation.
My echo report also states LV and RV hypertrophy without dilation.

My cardiologist give me without hesitation green light for cycling without any restriction in intensity.
Helpful - 0
Avatar universal
The doctror has seen some "left ventricular hypertrophy" starting, but I think it might be just the result of a lot of low-intencity running.
How about other runners/swimmers/cyclists with valve problems?
Helpful - 0
976897 tn?1379167602
Is there any of the report not shown above because I see nothing to indicate heart failure? everything looks on the money to me apart from the valve regurgitation.
Helpful - 0
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