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Do big athletes have big hearts? Impact of extreme anthropometry upon cardiac hypertrophy in professional male athletes.

Riding, NR; Salah, O; Sharma, S; Carré, F; O'Hanlon, R; George, KP; Hamilton, B; Chalabi, H; Whyte, GP; Wilson, MG (2012) Do big athletes have big hearts? Impact of extreme anthropometry upon cardiac hypertrophy in professional male athletes. Br J Sports Med, 46 (Suppl 1). i90-i97. ISSN 1473-0480 https://doi.org/10.1136/bjsports-2012-091258
SGUL Authors: Sharma, Sanjay

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Abstract

AIM: Differentiating physiological cardiac hypertrophy from pathology is challenging when the athlete presents with extreme anthropometry. While upper normal limits exist for maximal left ventricular (LV) wall thickness (14 mm) and LV internal diameter in diastole (LVIDd, 65 mm), it is unknown if these limits are applicable to athletes with a body surface area (BSA) >2.3 m(2). PURPOSE: To investigate cardiac structure in professional male athletes with a BSA>2.3 m(2), and to assess the validity of established upper normal limits for physiological cardiac hypertrophy. METHODS: 836 asymptomatic athletes without a family history of sudden death underwent ECG and echocardiographic screening. Athletes were grouped according to BSA (Group 1, BSA>2.3 m(2), n=100; Group 2, 2-2.29 m(2), n=244; Group 3, <1.99 m(2), n=492). RESULTS: There was strong linear relationship between BSA and LV dimensions; yet no athlete with a normal ECG presented a maximal wall thickness and LVIDd greater than 13 and 65 mm, respectively. In Group 3 athletes, Black African ethnicity was associated with larger cardiac dimensions than either Caucasian or West Asian ethnicity. Three athletes were diagnosed with a cardiomyopathy (0.4% prevalence); with two athletes presenting a maximal wall thickness >13 mm, but in combination with an abnormal ECG suspicious of an inherited cardiac disease. CONCLUSION: Regardless of extreme anthropometry, established upper limits for physiological cardiac hypertrophy of 14 mm for maximal wall thickness and 65 mm for LVIDd are clinically appropriate for all athletes. However, the abnormal ECG is key to diagnosis and guides follow-up, particularly when cardiac dimensions are within accepted limits.

Item Type: Article
Additional Information: This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode
Keywords: Adolescent, Adult, Anthropometry, Athletes, Body Size, Body Surface Area, Cardiomegaly, Exercise-Induced, Echocardiography, Electrocardiography, Humans, Hypertrophy, Left Ventricular, Male, Physical Examination, Sports, Young Adult, Humans, Hypertrophy, Left Ventricular, Echocardiography, Electrocardiography, Physical Examination, Anthropometry, Body Size, Body Surface Area, Sports, Adolescent, Adult, Male, Young Adult, Athletes, Cardiomegaly, Exercise-Induced, Science & Technology, Life Sciences & Biomedicine, Sport Sciences, SPORT SCIENCES, LEFT-VENTRICULAR HYPERTROPHY, M-MODE ECHOCARDIOGRAPHY, SUDDEN-DEATH, ELECTROCARDIOGRAPHIC ABNORMALITIES, MAGNETIC-RESONANCE, ETHNIC-DIFFERENCES, FOOTBALL PLAYERS, BLOOD-PRESSURE, UPPER LIMIT, BODY-SIZE, 11 Medical And Health Sciences, 09 Engineering, 13 Education, Sport Sciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Br J Sports Med
ISSN: 1473-0480
Language: eng
Dates:
DateEvent
November 2012Published
24 October 2012Published Online
10 July 2012Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 3.0
PubMed ID: 23097487
Web of Science ID: WOS:000310452400016
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110702
Publisher's version: https://doi.org/10.1136/bjsports-2012-091258

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