0538: Rheumatic valvular detected during the medical examination of non-counter-indications to the practice of the high level sport: result of a systematic evaluation

IntroductionThe cardiovascular assessment during the first medical examination of of noncounter-indications to the practice of the high level sport has systematically a heart Doppler ultrasound according to the consensus of National Center for Sport’s Medicine and Science (NCSMS).ObjectiveTo study the prevalence of rheumatic valve disease detected during the systematice echocardiographic assessment of Tunisian elite athletes.Materials and MethodsWe retrospectively studied the data of all the TTE carried out in the NCSMS from 1998 to 2009 (4254 heart Doppler ultrasound performed). The study population was composed of 2253 sportsmen including 586 girls (26.1%) and 1667 boys (73.9%). They are of average age of 20.58±4. 2 years. It is composed of national team’s members (31.5%), professional players (9.23%), sporting pupils (50.19%) and arbitrators (9.23%).Results We report 628 cardiac anomalies with good left ventricular function, consistent with the practice of competitive sports, mainly 173 cases of rheumatic valvular disease (27.5%) representing 94% of all valvular abnormalities observed.Rheumatic mitral leak was found in 122 cases (70.5%) with the combination of a moderate dilatation of the LV in 7 cases only. 40 athletes (32.7%) received only their routine annual echocardiographic controls whose data were similar to initial results, with the exception of three cases with valvular heart disease has evolved on a LV moderately dilated. We detected 34 rheumatic aortic insufficiency (19.6%), grade 1 to 2 (mild to moderate).Mitral and aortic valve disease (rheumatic mitral insufficiency grade I and rheumatic aortic insufficiency grade I) were observed in 17 athletes (9.9%). Six of them have benefited from echocardiographic control that was similar to the initial one.ConclusionOur study therefore to an echo-cardiographic description of the various rheumatic valve disease that can be observed in the athlete population and is compatible with the sport