Abstract
Background
Studies exploring the extent of aortic root dilation across the different types of
sport are limited. We aimed to define the physiological limits of aortic remodelling
in a large population of healthy elite athletes in comparison to non-athletic controls.
Methods
1995 consecutive athletes evaluated at the Institute of Sports Medicine (Rome, Italy)
and 515 healthy controls underwent a comprehensive cardiovascular screening. The aortic
diameter was measured at the level of the sinuses of Valsalva. The 99th percentile
from the mean of the aortic diameter in the control population was used to define
an abnormally enlarged aortic root dimension.
Results
Athletes showed a larger aortic root diameter (30.6 [±3.3] vs. 28.1 [±3.1] mm, p-value
<0.001) than controls. The difference was evident in male and female athletes regardless
of sport predominant component and level of intensity. The 99th percentile value for
aortic root diameter in control males and females was 37 mm and 32 mm, respectively.
Based on these values, 50 (4.2%) male and 21 (2.6%) female athletes would have been
diagnosed with an enlarged aortic root. However, aortic root diameter of clinical
relevance, i.e., ≥40 mm, was observed in only 17 male athletes (0.85%), and did not
exceed >44 mm.
Conclusions
Athletes show a mild, although significant, increased aortic dimension in comparison
to healthy controls. The degree of aortic enlargement varies in relation to type of
sports and sex. Eventually, only a small minority of athletes exhibited a markedly
enlarged aortic diameter (i.e., ≥40 mm) in a range of clinical relevance.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Accepted:
February 12,
2023
Received in revised form:
January 25,
2023
Received:
December 4,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Acknowledgements
None.
Funding
None.
Competing interests
None declared.
Identification
Copyright
© 2023 Published by Elsevier Inc. on behalf of the Canadian Cardiovascular Society.
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- Editorial Commentary on: Aortic root diameter in highly-trained competitive athletesCanadian Journal of Cardiology
- PreviewDo elite athletes have larger ascending aortas than a control population? That is the question that this study seeks to answer. It is well known that the muscular chambers of the heart (right atrium, left atrium, right ventricle, left ventricle) mold themselves in response to pressure and/or volume loads. But, is the aorta capable of similar plasticity?
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