Echocardiographic measurements of aortic root diameter (ARD) in collegiate football Athletes at pre-participation evaluation

Autor: Katherine M Edenfield; Fred Reifsteck; Stephen Carek; Kimberly G Harmon; Michael C Dillon; Joan Street; James R Clugston; Breton Michael Asken
Sprache: Englisch
Veröffentlicht: 2019
Quelle: Directory of Open Access Journals: DOAJ Articles
Online Zugang: https://bmjopensem.bmj.com/content/5/1/e000546.full
https://doaj.org/toc/2055-7647
doi:10.1136/bmjsem-2019-000546
2055-7647
https://doaj.org/article/51799865e304476d91023c189301eee4
https://doi.org/10.1136/bmjsem-2019-000546
https://doaj.org/article/51799865e304476d91023c189301eee4
Erfassungsnummer: ftdoajarticles:oai:doaj.org/article:51799865e304476d91023c189301eee4

Zusammenfassung

BackgroundSome remodelling of the aortic root may be expected to occur with exercise but can already vary due to different body sizes, compositions and genetic predispositions. Attributing the cause of borderline aortic root diameter (ARD) values to either physiological or pathological conditions in American college football athletes is difficult as there is very limited normal reference values in this population. Body surface area (BSA) specific norms are thought to be useful in other cardiac measurements of football athletes.MethodsA retrospective cohort review of pre-participation examination (PPE) transthoracic echocardiogram data from collegiate football athletes was performed. ARD was analysed by field position (linemen, n=137; non-linemen, n=238), race (black, n=216; white, n=158) and BSA for predictive value and associations. Values were compared with non-athlete norms, and collegiate football athlete-specific normal tables were created.ResultsOnly 2.7% of football athletes had ARD measurements above normal non-athlete reference values and the mean athlete ARD values were lower than non-athlete values. No athletes had an aortic root >40 mm or were disqualified due to underlying cardiac pathology. Univariate analyses indicated linemen position and increasing BSA was associated with larger values for ARD. BSA outperformed race in predicting ARD. Normal tables were created for ARD stratified by BSA group classification (low, average and high BSA). Proposed clinical cut-offs for normal and abnormal values are reported for raw echocardiograph metrics and their BSA indexed scores.ConclusionsNon-athlete reference values for ARD appear applicable for defining upper limits of normal for most collegiate football athletes. BSA-specific normal values may be helpful in interpreting results for athletes that exceed non-athlete norms.