Background and objectives: Aortic rupture is known as one of the potential causes of sudden cardiac death in athletes. Nevertheless, adaptation strategies for aortic root dilation in athletes vary. The purpose of this study was to investigate aortic root adaptation to physical workload and to determine if aortic roots and left ventricle sizes are contingent upon the physical workload. Materials and Methods: Echocardiography was applied to 151 subjects to measure the aortic root at aortic valve annulus (AA) and at sinus of Valsalva (VS). 122 were athletes (41 females and 81 males) and 29 were non-athletes (14 females and 15 males). Of the 41 female athletes, 32 were endurance athletes, and 9 were strength athletes. From 81 male athletes, 56 were endurance athletes, and 25 were strength athletes. AA and VS mean values for the body surface area were presented as AA relative index with body surface area (rAA) and VS relative index with body surface area (rVS). Left ventricle (LV) measures included LV end-diastolic diameter (LVEDD), interventricular septum thickness in diastole (IVSTd), LV posterior wall thickness in diastole (LVPWTd), LV mass (LVM), LV mass index, and LV end-diastolic diameter index (LVEDDI). Results: Results indicated that VS was higher in female athletes (28.9 ± 2.36 mm) than in non-athletes (27.19 ± 2.87 mm, p = 0.03). On the other hand, rAA was higher in strength athletes (12.19 ± 1.48 mm/m2) than in endurance athletes (11.12 ± 0.99 mm/m2, p = 0.04). Additionally, rVS and rAA were higher in female strength athletes (17.19 ± 1.78 mm/m2, 12.19 ± 1.48 mm/m2) than female basketball players (15.49 ± 1.08 mm/m2, p = 0.03, 10.75 ± 1.06 mm/m2, p = 0.02). No significant differences regarding aortic root were found between male athletes and non-athletes. Statistically significant positive moderate correlations were found between VS and LVEDD, LVM, IVSTd, LVPWTd, rVS, and LVEDDI parameters in all athletes. Conclusion: The diameter of Valsalva sinus was greater in female athletes compared to non-athletes. The rAA mean value for body surface area was greater in female athletes practising strength sports as compared to their counterparts who were practising endurance sports. The diameter of the aortic root at sinuses positively correlated with the LV size in all athletes.
Background. Since athletes have a higher risk to experience cardiovascular system complications, this gives us an important reason for further investigation. Early detection of pathological hypertrophy of the left ventricle may exclude athletes from sports activities and prevent complications and possible death. Methods. In our study, 75 patients underwent transthoracic echocardiography (TTE). The values of left ventricle were measured: left ventricle end-diastolic diameter (LVEDD), interventricular septum thickness in diastole (IVSTd), LV posterior wall thickness in diastole (LVPWTd), LV mass (LVM), LV mass index (LVMI), LV end-diastolic diameter index (LVEDDI). Standard 12-lead ECG was recorded at 25 mm/s and with standard calibration of 10 mm/ mV from a patient in a supine position. Results. When we compared results of LVH according to ECG and TTE, ECG showed higher count of athletes with marginal changes and less LVH compared to TTE in female endurance and male athletes. Moreover, moderate positive correlation between LV mass and R wave size (V5) (r = .617) was found in female endurance athletes. Furthermore, high positive correlation between LVEDD and QRS interval length (r = .911) was found in female strength athletes. Also, moderate negative correlation (r = –.603) between heart electrical axis and R wave size (V5) was found in male endurance athletes. Conclusions. Knowledge of the ECG changes associated with the type and intensity of exercise, race, age and gender can lower the traditionally high number of false positives, thus reducing unnecessary investigations. In our study, ECG showed higher count of athletes with marginal changes and less LVH compared to TTE in women endurance, men strength and endurance groups.
Aortic rupture is known as one of the potential causes of sudden cardiac death in athletes. Nevertheless, adaptation strategies for aortic root dilation in athletes vary. The purpose of this study was to investigate aortic root adaptation to physical workload and to determine if aortic root’s and left ventricle sizes are contingent upon the physical workload. Echocardiography was applied to 151 subjects to measure the aortic root at aortic valve annulus (AA) and at sinus of Valsalva (VS). 122 were athletes (41 females and 81 males) and 29 were non-athletes (14 females and 15 males). Of the 41 female athletes, 32 were endurance athletes, and 9 strength athletes. From 81 male athletes, 56 were endurance athletes, and 25 were strength athletes. AA and VS mean values for the body surface area were presented as rAA and rVS. Left ventricle (LV) meaures incuded LV end-diastolic diameter (LVEDD), interventricular septum thickness in diastole (IVSTd), LV posterior wall thickness in diastole (LVPWTd), LV mass (LVM), LV mass index, LV end-diastolic diameter index (LVEDDI). Results indicated that VS was higher in female athletes (28.9±2.36mm) than in non-athletes (27.19±2.87mm, p=0.03). On the other hand, rAA was higher in strength athletes (12.19±1.48mm/m2) than in endurance athletes (11.12±0.99mm/m2, p=0.04). Additionally, rVS and rAA were higher in female strength athletes (17.19±1.78mm/m2, 12.19±1.48mm/m2) than female basketball players (15.49±1.08mm/m2, p=0.03, 10.75±1.06 mm/m2, p=0.02). Statistically significant positive moderate correlations were found between VS and LVEDD, LVM, IVSTd, LVPWTd, rVS and LVEDDI parameters in all athletes. The diameter of Valsalva sinus was greater in female athletes compared to non-athletes. The rAA mean value for body surface area was greater in female athletes practising strength sports as compared to their counterparts who were practising endurance sports. The diameter of the aortic root at sinuses positively correlated with the LV size in all athletes. Trial was registered at ClinicalTrials.gov Identifier: NCT03656861, September 3, 2018 (retrospectively registered).
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