Prevalence and Clinical Significance of Left Atrial Remodeling in Competitive Athletes
Antonio Pelliccia, MD*,*,
Barry J. Maron, MD ,
Fernando M. Di Paolo, MD*,
Alessandro Biffi, MD*,
Filippo M. Quattrini, MD*,
Cataldo Pisicchio, MD*,
Alessandra Roselli, MD*,
Stefano Caselli, MD* and
Franco Culasso, PhD
* National Institute of Sports Medicine, Italian National Olympic Committee, Rome, Italy
The Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
Department of Experimental Medicine, University La Sapienza, Rome, Italy
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Figure 1 Distribution of transverse left atrium dimensions in 1,777 highly trained athletes. Data are shown separately for female (grey bars) and male (black bars) athletes. Twenty percent of athletes had an enlarged left atrium (range, 40 to 50 mm), including 2% with an atrial dimension  45 mm.
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Figure 2 Stop-frame two-dimensional parasternal long-axis view (A), M-mode echocardiogram (B), and four-chamber (C) view from a 26-year-old elite rower, showing left atrial enlargement (transverse dimension = 45 mm). The left atrium is globally enlarged in both the transverse and longitudinal dimensions; left and right ventricular and right atrial chambers are also enlarged. AO = aortic root; LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle.
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Figure 3 Prevalence of supraventricular tachyarrhythmias (i.e., paroxysmal atrial fibrillation or supraventricular tachycardia) before or at initial evaluation in our institute with respect to left atrial (LA) dimension, as assessed by echocardiography in 1,777 athletes. AF = paroxysmal atrial fibrillation; CV = cardiovascular; SVT = supraventricular tachycardia.
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