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Prevalence and progression of aortic root dilatation in highly trained young athletes.

Gati, S; Malhotra, A; Sedgwick, C; Papamichael, N; Dhutia, H; Sharma, R; Child, AH; Papadakis, M; Sharma, S (2019) Prevalence and progression of aortic root dilatation in highly trained young athletes. Heart, 105 (12). pp. 920-925. ISSN 1468-201X https://doi.org/10.1136/heartjnl-2018-314288
SGUL Authors: Sharma, Sanjay

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Abstract

OBJECTIVES: Aortic root dilatation is reported in young athletes; however, it is unclear whether such remodelling is physiological or, whether it represents a potential aortopathy. This observational study investigated the prevalence and progression of aortic root dilatation in young athletes competing at regional or national level. METHODS: Between 2003 and 2015, 3781 athletes aged 19±5.9 years (63.3% male) underwent echocardiography as part of a cardiac screening programme to identify athletes with structural abnormalities. Athletes trained for an average of 16.7 hours per week. Aortic diameter was measured at the level of sinuses of Valsalva. Results were compared with 806 controls. Athletes with an enlarged aortic diameter were followed up for 5±1.5 years. RESULTS: Athletes revealed a larger mean aortic diameter compared with controls (28.3±4.1 vs 27.8±4.1 mm; p=0.01). The 99th percentile value for aortic diameter in the athlete cohort was defined as the upper limit and was 40 mm in males and 38 mm in females. The aortic diameter measured >40 mm in five male (0.17%) (40-43 mm) and >38 mm in six female (0.4%) (39-41 mm) athletes. During follow-up, none of the athletes with an enlarged aortic diameter showed progressive aortic enlargement compared with the first assessment (40.6±0.9 vs 40.5±0.7 mm in males; (p=0.111) and 38.3±0.6 vs 38.0±0.7 mm in females; (p=0.275)). CONCLUSIONS: A small minority (0.3%) of athletes reveal an enlarged aortic diameter. Medium-term follow-up does not reveal progressive enlargement of the aortic diameter indicative of aortopathy. Longer surveillance studies are necessary to elucidate the precise significance of an enlarged aortic diameter in athletes.

Item Type: Article
Additional Information: This article has been accepted for publication in Heart, 2019 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/heartjnl-2018-314288. © Author(s) (or their employer(s)) 2019.
Keywords: aortic root, athlete’s heart, exercise, 1102 Cardiovascular Medicine And Haematology, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Heart
ISSN: 1468-201X
Language: eng
Dates:
DateEvent
22 May 2019Published
25 March 2019Published Online
15 January 2019Accepted
Publisher License: Publisher's own licence
PubMed ID: 30910821
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110772
Publisher's version: https://doi.org/10.1136/heartjnl-2018-314288

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