Abstract 19357: The Prevalence and Significance of Aortic Root Dilation in Highly Trained Athletes: `Relevance to the Bethesda Consensus Panel Guidelines'
Introduction: Studies in highly trained athletes reveal increased aortic root dimensions compared with controls. It is unclear whether aortic root dilation represents ‘athlete’s heart’ or a potential aortopathy. The Bethesda recommendations suggest that athletes with an aortic root dimension of ≥40mm should only participate in low-intensity competitive sport. This study sought to investigate the prevalence and clinical significance of aortic root dilation in nationally ranked British athletes.
Methods: Between 2004-2012, 1160 athletes (63% male; age 20.7±6.0 years; range 14-35 years; BSA 2.01±0.34m2) participating in 31 sporting disciplines, underwent echocardiography as part of a pre-participation screening evaluation. Aortic root dimensions, measured at the sinus of Valsalva level, were analysed according to ESC guidelines.
Results were compared to 415 healthy controls (57% male; age 22.1±6.4 years; range 14-35 years) of similar size (BSA 1.98±0.36m2) and 50 patients with Marfan syndrome (54% male; age range 18-68 years). Individuals with a bicuspid valve had been excluded. Results: Athletes and controls exhibited similar mean aortic root dimensions (27.9±4.1mm, range: 16-43mm, vs. 27.9±4.3mm, range: 17-38mm; p=1.000). Marfan patients had greater mean aortic root dimensions compared with athletes (39.1±5.1mm; range 26-48 mm vs. 27.9±4.1mm). The aortic root was ≥40 mm in 6 male athletes (0.8%) and 1 female athlete (0.2%), compared with none in the controls. In contrast, 22 males (81%) and 6 females (26%) with Marfan syndrome showed an aortic root ≥40mm (p<0.0001).
Conclusion: Unlike other cardiac dimensions, athletes generally exhibit similar mean aortic root dimensions to controls. In absolute terms, few British athletes reveal an aortic root dimension ≥40mm. This cross sectional study provides support for the guidelines set by the expert Bethesda consensus panel.
- © 2012 by American Heart Association, Inc.