CLINICAL STUDY: CARDIAC IMAGING
Echocardiographic characteristics of professional football players
William B. Abernethy, III, MD*,
Joseph K. Choo, MD* and
Adolph M. Hutter, Jr, MD*,*
* Cardiac Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
Manuscript received September 20, 2001;
revised manuscript received July 8, 2002,
accepted August 20, 2002.
* Reprint requests and correspondence: Dr. Adolph M. Hutter, Jr., ACC 467 Massachusetts General Hospital, 14 Parkman Street, Boston, Massachusetts 02114, USA.
hutter.adolph{at}mgh.harvard.edu
OBJECTIVES: We examined the echocardiographic characteristics of highly trained American football players.
BACKGROUND: Intense physical training is associated with morphologic and physiologic cardiac changes often referred to as the "athlete’s heart." Echocardiographic features peculiar to elite football players have not been described.
METHODS: We studied cardiac morphology and function as assessed by rest and stress echocardiography in 156 asymptomatic National Football League players. Resting and stress ejection fraction (EF), wall thickness, and diastolic left ventricular internal diameter (LVID) were measured. Left ventricular (LV) mass was calculated, as was relative wall thickness (RWT) defined as septal and posterior wall thickness divided by LVID. Control data were obtained from published studies.
RESULTS: The mean LVID (53 ± 0.5 mm) and maximal wall thickness (11.2 ± 0.2 mm) were increased over normal reported control subjects. There was a correlation between LVID and body weight (p = 0.01) and body surface area (BSA) (p = 0.01). The average LVID indexed to BSA was 23 ± 2 mm/M2. There was also a correlation between maximal wall thickness and body weight (p = 0.01) and BSA (p = 0.01). The average wall thickness indexed to BSA was 5.05 ± 0.88 mm/M2. Of the players, 23% had evidence of LV hypertrophy. Two players had an increased septal-to-posterior-wall-thickness ratio ( 1.3), although no player had an outflow gradient. The RWT for the players was 0.424 (± 0.1). The mean resting EF was 58% (± 4.4%), and every player undergoing exercise testing had an appropriate hyperdynamic response in cardiac function.
CONCLUSIONS: Both wall thickness and LVID of elite American football players are increased and correlate with body size. There is a high RWT, reflecting an emphasis on strength training. The LV EF was normal and not supranormal, as is sometimes believed. Regardless of the resting EF, all players had hyperdynamic cardiac responses with exercise.
|
Abbreviations and Acronyms
| | BSA | | body surface area | | EF | | ejection fraction | | IVST | | interventricular septal wall thickness | | LV | | left ventricular | | LVID | | left ventricular internal diameter | | LVM | | left ventricular mass | | PWT | | posterior wall thickness | | RWT | | relative wall thickness |
|
This article has been cited by other articles:
|
|
|
|
 
A. La Gerche, A. J. Taylor, and D. L. Prior
Athlete's Heart: The Potential for Multimodality Imaging to Address the Critical Remaining Questions.
J. Am. Coll. Cardiol. Img.,
March 1, 2009;
2(3):
350 - 363.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G J King, R T Murphy, I Almuntaser, K Bennett, E Ho, and A S Brown
Alterations in myocardial stiffness in elite athletes assessed by a new Doppler index
Heart,
October 1, 2008;
94(10):
1323 - 1325.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Luthi, M. Zuber, M. Ritter, E. N. Oechslin, R. Jenni, B. Seifert, S. Baldesberger, and C. H. Attenhofer Jost
Echocardiographic findings in former professional cyclists after long-term deconditioning of more than 30 years
Eur J Echocardiogr,
March 1, 2008;
9(2):
261 - 267.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Q Osborn, W. C Taylor, K. Oken, M. Luzano, M. Heckman, and G. Fletcher
Echocardiographic characterisation of left ventricular geometry of professional male tennis players
Br. J. Sports Med.,
November 1, 2007;
41(11):
789 - 792.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Maron, P. D. Thompson, M. J. Ackerman, G. Balady, S. Berger, D. Cohen, R. Dimeff, P. S. Douglas, D. W. Glover, A. M. Hutter Jr, et al.
Recommendations and Considerations Related to Preparticipation Screening for Cardiovascular Abnormalities in Competitive Athletes: 2007 Update: A Scientific Statement From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: Endorsed by the American College of Cardiology Foundation
Circulation,
March 27, 2007;
115(12):
1643 - 1655.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Maron and A. Pelliccia
The Heart of Trained Athletes: Cardiac Remodeling and the Risks of Sports, Including Sudden Death
Circulation,
October 10, 2006;
114(15):
1633 - 1644.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. M. Harris, A. Sponsel, A. M. Hutter Jr., and B. J. Maron
Brief communication: Cardiovascular screening practices of major North American professional sports teams.
Ann Intern Med,
October 3, 2006;
145(7):
507 - 511.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Abergel, G. Chatellier, A. A. Hagege, A. Oblak, A. Linhart, A. Ducardonnet, and J. Menard
Serial left ventricular adaptations in world-class professional cyclists: Implications for disease screening and follow-up
J. Am. Coll. Cardiol.,
July 7, 2004;
44(1):
144 - 149.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Maron
Sudden Death in Young Athletes
N. Engl. J. Med.,
September 11, 2003;
349(11):
1064 - 1075.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Scharhag, A. Urhausen, and W. Kindermann
Anabolic steroid-induced echocardiographic characteristics of professional football players?
J. Am. Coll. Cardiol.,
August 6, 2003;
42(3):
588 - 588.
[Full Text]
[PDF]
|
|
|
|
|
|
|
The Athlete's Heart: Echocardiographic Findings
Journal Watch Cardiology,
March 28, 2003;
2003(328):
5 - 5.
[Full Text]
|
|
|
|
