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Hamburger RF, Taha Y, Ruzieh M, Clugston JR, Handberg EM, Reifsteck F, Martinez MW, Pepine CJ, Edenfield KM. Longitudinal cardiac remodeling in collegiate American football players as assessed by echocardiography during their collegiate career. Clin Cardiol 2023; 46:1090-1096. [PMID: 37573574 PMCID: PMC10540003 DOI: 10.1002/clc.24121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/19/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Studies on the longitudinal effects of intense physical training on cardiac remodeling are limited, especially in American collegiate football players. HYPOTHESIS College-level American football training will result in remodeling in a pattern consistent of a sport with moderate static and dynamic demands with increases in both wall and chamber sizes. METHODS We studied 85 American collegiate football players who underwent transthoracic echocardiogram (TTE) for asymptomatic or mild COVID-19-related illness and compared the changes in echo dimensions to their preparticipation screening TTE. Pre- and posttraining variables were compared using a paired t-test for normally distributed variables. RESULTS Mean age was 19 years ± 1 and 61% of athletes were Black. Mean follow-up between TTEs was 21 ± 13 months. There was an increase in left atrial volume index (26.4 ± 5.5 to 32.8 ± 8.4 mL/m2 , p < .001), LV end diastolic diameter (5.13 ± 0.4 to 5.27 ± 0.4 cm, p = .003), basal RV diameter (3.28 ± 0.7 to 3.83 ± 0.5 cm, p = <.001), LV mass index (86.7 ± 15.3 to 90.1 ± 15.3, p = .015), and aortic root diameter (3.1 ± 0.4 to 3.2 ± 0.3 cm, p = .03) from pre- to posttraining, with a slightly greater magnitude in athletes with >2 years of training. Presence of left atrial enlargement (≥35 mL/m2 ) increased from 2.9% to 29% pre- to postparticipation in athletes with >2 years training. No significant changes in wall thickness, diastolic function, or right ventricular systolic function were observed. CONCLUSION American football players college-level training was associated with increases in left and right ventricular chamber sizes, left atrial size, and aortic root diameter.
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Affiliation(s)
- Robert F. Hamburger
- Division of Cardiovascular MedicineUniversity of Florida College of MedicineGainesvilleFloridaUSA
- Division of CardiologyMalcom Randall VA Medical CenterGainesvilleFloridaUSA
| | - Yasmeen Taha
- Department of MedicineUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Mohammed Ruzieh
- Division of Cardiovascular MedicineUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - James R. Clugston
- Department of Community Health and Family MedicineUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Eileen M. Handberg
- Division of Cardiovascular MedicineUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Fred Reifsteck
- Department of Sports MedicineUniversity of GeorgiaAthensGeorgiaUSA
| | | | - Carl J. Pepine
- Division of Cardiovascular MedicineUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Katherine M. Edenfield
- Department of Community Health and Family MedicineUniversity of Florida College of MedicineGainesvilleFloridaUSA
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Iso Y, Kitai H, Ichimori K, Kubota M, Tsujiuchi M, Nagumo S, Toshida T, Yonechi T, Ebato M, Suzuki H. Cardiac Structure and Cardiorespiratory Fitness in Young Male Japanese Rugby Athletes. J Cardiovasc Dev Dis 2023; 10:jcdd10010012. [PMID: 36661907 PMCID: PMC9861008 DOI: 10.3390/jcdd10010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/21/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023] Open
Abstract
Limited data are available on athlete's heart for rugby athletes. This study aimed to investigate cardiac structure and its relationship with cardiorespiratory fitness in young Japanese rugby athletes. A prospective cross-sectional study using echocardiography and cardiopulmonary exercise testing (CPET) was conducted on 114 male collegiate rugby players. There was a higher prevalence of increased left ventricular (LV), atrial, and aortic dimensions in the young athletes than that in previously published reports, whereas the wall thickness was within the normal range. Anthropometry and CPET analyses indicated that the forwards and backs presented muscular and endurance phenotypes, respectively. Indexed LV and aortic dimensions were significantly larger in the backs than in the forwards, and the dimensions significantly correlated with oxygen uptake measured by CPET. On the four-tiered classification for LV hypertrophy, abnormal LV geometry was found in 16% of the athletes. Notably, the resting systolic blood pressure was significantly higher in athletes with concentric abnormal geometry than in the other geometry groups, regardless of their field positions. Japanese young athletes may exhibit unique phenotypes of cardiac remodeling in association with their fitness characteristics. The four-tiered LV geometry classification potentially offers information regarding the subclinical cardiovascular risks of young athletes.
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Affiliation(s)
- Yoshitaka Iso
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan
- Division of Cardiology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama 227-8518, Japan
- Correspondence: ; Tel.: +81-45-971-1151
| | - Hitomi Kitai
- Department of Clinical Pathology and Laboratory, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan
- Department of Physical Therapy, Showa University School of Nursing and Rehabilitation Sciences, Yokohama 226-8555, Japan
| | - Keiko Ichimori
- Department of Clinical Pathology and Laboratory, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan
| | - Megumi Kubota
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan
- Division of Cardiology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama 227-8518, Japan
| | - Miki Tsujiuchi
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan
- Division of Cardiology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama 227-8518, Japan
| | - Sakura Nagumo
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan
- Division of Cardiology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama 227-8518, Japan
| | - Tsutomu Toshida
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan
| | - Toru Yonechi
- Faculty of Sport Science, Nippon Sport Science University, Yokohama 227-0033, Japan
| | - Mio Ebato
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan
| | - Hiroshi Suzuki
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan
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Boraita A, Díaz-Gonzalez L, Valenzuela PL, Heras ME, Morales-Acuna F, Castillo-García A, Lucia MJ, Suja P, Santos-Lozano A, Lucia A. Normative Values for Sport-Specific Left Ventricular Dimensions and Exercise-Induced Cardiac Remodeling in Elite Spanish Male and Female Athletes. Sports Med - Open 2022; 8:116. [PMID: 36107355 PMCID: PMC9478009 DOI: 10.1186/s40798-022-00510-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 08/18/2022] [Indexed: 11/25/2022]
Abstract
Background There is debate about the magnitude of geometrical remodeling [i.e., left ventricle (LV) cavity enlargement vs. wall thickening] in the heart of elite athletes, and no limits of normality have been yet established for different sports. We aimed to determine sex- and sport-specific normative values of LV dimensions in elite white adult athletes. Methods This was a single-center, retrospective study of Spanish elite athletes. Athletes were grouped by sport and its relative dynamic/static component (Mitchell’s classification). LV dimensions were measured with two-dimensional-guided M-mode echocardiography imaging to compute normative values. We also developed an online and app-based calculator (https://sites.google.com/lapolart.es/athlete-lv/welcome?authuser=0) to provide clinicians with sports- and Mitchell’s category-specific Z-scores for different LV dimensions. Results We studied 3282 athletes (46 different sports, 37.8% women, mean age 23 ± 6 years). The majority (85.4%) showed normal cardiac geometry, particularly women (90.9%). Eccentric hypertrophy was relatively prevalent (13.4%), and concentric remodeling or hypertrophy was a rare finding (each < 0.8% of total). The proportion of normal cardiac geometry and eccentric hypertrophy decreased and increased, respectively, with the dynamic (in both sexes) or static component (in male athletes) of the sport irrespective of the other (static or dynamic) component. The 95th percentile values of LV dimensions did not exceed the following limits in any of the Mitchell categories: septal wall thickness, 12 mm (males) and 10 mm (females); LV posterior wall, 11 mm and 10 mm; and LV end-diastolic diameter, 64 mm and 57 mm. Conclusions The majority of elite athletes had normal LV geometry, and although some presented with LV eccentric hypertrophy, concentric remodeling or hypertrophy was very uncommon. The present study provides sport-specific normative values that can serve to identify those athletes for whom a detailed examination might be recommendable (i.e., those exceeding the 95th percentile for their sex and sport). Supplementary Information The online version contains supplementary material available at 10.1186/s40798-022-00510-2.
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Slankamenac J, Milovancev A, Klasnja A, Gavrilovic T, Sekulic D, Kesic MG, Trivic T, Kolarov V, Drid P. Echocardiographic Characterization of Left Heart Morphology and Function in Highly Trained Male Judo Athletes. Int J Environ Res Public Health 2022; 19:ijerph19148842. [PMID: 35886693 PMCID: PMC9325159 DOI: 10.3390/ijerph19148842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 02/01/2023]
Abstract
The long-term practice of judo can lead to various changes in the heart including increased dimensions of the left ventricle in diastole and thickening of the interventricular septum and the posterior wall of the left ventricle. This study aimed to assess left ventricular morphology and function in elite male judokas. A comparative cross-sectional study was conducted that included a total of 20 subjects, 10 judokas, and 10 healthy non-athletes aged 24 ± 2.85 years. Demographic and anthropometric data were analyzed. All subjects underwent a medical examination and a two-dimensional transthoracic echocardiogram. Different parameters of left ventricular morphology and function were measured and compared between athletes and non-athletes. Left ventricle mass and LV mass index were higher in judokas than in non-athletes (p < 0.05), as well as PW thickness (9.78 ± 0.89 mm vs. 8.95 ± 0.76 mm). A total of six (n = 6) of athletes had eccentric hypertrophy, while others had normal heart geometry. LVEDd, LVEDs, LVEDd/BSA, and LVEDs/BSA were significantly higher in judokas (p < 0.05). LVEDd in athletes ranged from 48 to 62 mm. These values, combined with normal diastolic function, ejection fraction, and shortening fraction, indicate that the judokas’ cardiac adaptation was physiological rather than pathological.
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Affiliation(s)
- Jelena Slankamenac
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (J.S.); (T.T.)
| | - Aleksandra Milovancev
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; (A.M.); (A.K.); (V.K.)
- Institute of Cardiovascular Diseases of Vojvodina, 21204 Sremska Kamenica, Serbia
| | - Aleksandar Klasnja
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; (A.M.); (A.K.); (V.K.)
| | - Tamara Gavrilovic
- Serbian Institute of Sport and Sports Medicine, 11000 Belgrade, Serbia;
| | - Damir Sekulic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia; (D.S.); (M.G.K.)
| | - Marijana Geets Kesic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia; (D.S.); (M.G.K.)
| | - Tatjana Trivic
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (J.S.); (T.T.)
| | - Violeta Kolarov
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia; (A.M.); (A.K.); (V.K.)
- Institute for Pulmonary Diseases of Vojvodina, 21204 Sremska Kamenica, Serbia
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (J.S.); (T.T.)
- Correspondence:
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Yeo TJ, Wang M, Grignani R, McKinney J, Koh LP, Tan FHY, Chan GCT, Tay N, Chan SP, Lee CH, Oxborough D, Malhotra A, Sharma S, Richards AM. Electrocardiographic and Echocardiographic Insights From a Prospective Registry of Asian Elite Athletes. Front Cardiovasc Med 2022; 8:799129. [PMID: 35047579 PMCID: PMC8761771 DOI: 10.3389/fcvm.2021.799129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/29/2021] [Indexed: 01/31/2023] Open
Abstract
Background: Asian representation in sport is increasing, yet there remains a lack of reference values for the Asian athlete's heart. Consequently, current guidelines for cardiovascular screening recommend using Caucasian athletes' norms to evaluate Asian athletes. This study aims to outline electrocardiographic and echocardiographic characteristics of the Asian athlete's heart using a Singaporean prospective registry of Southeast (SE) Asian athletes. Methods and Results: One hundred and fifty elite athletes, mean age of 26.1 ± 5.7 years (50% males, 88% Chinese), were evaluated using a questionnaire, 12-lead electrocardiogram (ECG) and transthoracic echocardiogram. All ECGs were analyzed using the 2017 International Recommendations. Echocardiographic data were presented by gender and sporting discipline. The prevalence of abnormal ECGs among SE Asian athletes was 6.7%—higher than reported figures for Caucasian athletes. The abnormal ECGs comprised mainly anterior T wave inversions (ATWI) beyond lead V2, predominantly in female athletes from mixed/endurance sport (9.3% prevalence amongst females). None had echocardiographic structural abnormalities. Male athletes had reduced global longitudinal strain compared to females (−18.7 ± 1.6 vs. −20.7 ± 2.1%, p < 0.001). Overall, SE Asian athletes had smaller left ventricular cavity sizes and wall thickness compared to non-Asian athletes. Conclusion: SE Asian athletes have higher abnormal ECG rates compared to Caucasian athletes, and also demonstrate structural differences that should be accounted for when interpreting their echocardiograms compared to athletes of other ethnicities.
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Affiliation(s)
- Tee Joo Yeo
- Cardiac Department, National University Heart Centre Singapore, Singapore, Singapore.,Cardiovascular Research Institute, National University Heart Centre Singapore, Singapore, Singapore
| | - Mingchang Wang
- National University Hospital Sports Centre, National University Hospital, Singapore, Singapore
| | - Robert Grignani
- Department of Paediatrics, National University Hospital, Singapore, Singapore
| | - James McKinney
- SportsCardiologyBC, University of British Columbia, Vancouver, BC, Canada
| | - Lay Pheng Koh
- Cardiac Department, National University Heart Centre Singapore, Singapore, Singapore
| | - Frankie Hun Yau Tan
- Sport Science and Medicine Centre, Singapore Sport Institute, Sport Singapore, Singapore, Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Gregory Chung Tsing Chan
- Sport Science and Medicine Centre, Singapore Sport Institute, Sport Singapore, Singapore, Singapore
| | - Nigel Tay
- Family Medicine Department, Cavendish Doctors, Auckland, New Zealand
| | - Siew-Pang Chan
- Cardiac Department, National University Heart Centre Singapore, Singapore, Singapore.,Cardiovascular Research Institute, National University Heart Centre Singapore, Singapore, Singapore
| | - Chi-Hang Lee
- Cardiac Department, National University Heart Centre Singapore, Singapore, Singapore.,Cardiovascular Research Institute, National University Heart Centre Singapore, Singapore, Singapore
| | - David Oxborough
- Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Aneil Malhotra
- Division of Cardiovascular Sciences, University of Manchester, Manchester NHS Foundation Trust, Manchester, United Kingdom.,Manchester Institute of Health and Performance, Manchester, United Kingdom
| | - Sanjay Sharma
- Cardiology Clinical Academic Group, St George's University of London, London, United Kingdom
| | - Arthur Mark Richards
- Cardiac Department, National University Heart Centre Singapore, Singapore, Singapore.,Cardiovascular Research Institute, National University Heart Centre Singapore, Singapore, Singapore
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Huang KC, Lin CE, Lin LY, Hwang JJ, Lin LC. Data-driven clustering supports adaptive remodeling of athlete's hearts: An echocardiographic study from the Taipei Summer Universiade. J Formos Med Assoc 2021:S0929-6646(21)00489-7. [PMID: 34740491 DOI: 10.1016/j.jfma.2021.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 09/16/2021] [Accepted: 10/20/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND/PURPOSE Sport-specific adaptations of athlete's hearts are still under investigation. This study sought to 1) identify athlete groups with similar characteristics by clustering echocardiographic data; 2) externally validate the data-driven clusters with sport classifications of various dynamic or static loads to support the conventional hypothesis-driven approach in delineating the athlete's heart. METHODS Anthropometric, echocardiographic and electrocardiographic assessments were collected during the 2017 Summer Universiade in Taiwan. Besides standard echocardiography and strain measurements, ventricular-arterial coupling (VAC) was assessed by the ratio of effective arterial elastance (Ea) to left ventricular end-systolic elastance (Ees) as calculated by a modified single-beat algorithm. RESULTS We grouped 598 elite athletes (348 male, age 23 ± 2.5 years, across 24 disciplines) using Mitchell's classification. The hypothesis-driven analysis showed dynamic training-related adaptations in heart rate and morphology, including ventricular size, mass, and stroke volume. In comparison, the unsupervised approach found two clusters for each sex. Male athletes participating in high dynamic-load exercises had larger chambers, supranormal diastolic functions, depressed Ees, lower Ea and preserved optimal VAC implicating the resting status of a reservoir-rich pump, which affirmed sport-specific adaptation. The female athletes could be clustered with more noticeable functional alterations, such as depressed biventricular strain. However, the imbalanced number between clusters impeded the validation of load-related remodeling. CONCLUSION Hierarchical clustering could analyze complicated multiparametric interactions among numerous echocardiography-derived phenotypes to discern the adaptive propensity of the athlete's heart. The endorsement or generation of hypotheses by a data-driven approach can be applied to various domains.
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Park JH, Kim KH, Rink L, Hornsby K, Cho JY, Cho GY, Lee JH, Seong IW, Jeong MH, Cho JG, Park JC. Left atrial enlargement and its association with left atrial strain in university athletes participated in 2015 Gwangju Summer Universiade. Eur Heart J Cardiovasc Imaging 2021; 21:865-872. [PMID: 32380526 DOI: 10.1093/ehjci/jeaa084] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 02/05/2020] [Accepted: 04/03/2020] [Indexed: 12/27/2022] Open
Abstract
AIMS Intensive and repetitive athletic training may result in cardiac geometric changes, but the determinants of left atrial (LA) enlargement (LAE) has been poorly studied. We investigated incidence and determinants of LAE and its association with LA strains in highly trained university athletes. METHODS AND RESULTS A total of 1073 athletes (451 females, 22.4 ± 2.4 years old) who were able to measure LA size, volume, and strains during 2015 Gwangju Summer Universiade were enrolled. LAE was defined as the increased LA volume index > 42 mL/m2. LA strains, reservoir, conduit, and contractile were measured by 2D speckle tracking method, and LA reservoir strain < 27.6% was considered as abnormal. LAE was developed in 205 athletes (19.1%). In univariate analysis, male [odds ratio (OR) = 1.679], Caucasian (OR = 1.746), non-African descent (OR = 1.804), body muscle mass (OR = 1.056), body fat mass (OR = 0.962), systolic blood pressure (OR = 1.012), heart rate (OR = 0.980), sports type with cardiovascular (CV) demand (OR = 1.474), training time (OR = 1.011), left ventricular (LV) global longitudinal strain (LVGLS, OR = 0.906), and LV stroke volume (LVSV, OR = 1.044) were significantly associated with LAE. In multivariate logistic regression analysis, heart rate (OR = 0.961) and sports type with CV demand (OR = 1.299), LVGLS (OR = 0.865) and LVSV (OR = 1.013) were independent determinants of LAE. Abnormal LA reservoir strain was noted in 56 athletes (5.2%), and the incidence of abnormal value was not different between two groups; 42 athletes (4.8%) in LAE vs. 14 (6.8%) in no LAE group (P = 0.293). CONCLUSION LAE was common in university athletes (19.1%) and associated with heart rate, sports type with CV demand, LVGLS, and LVSV. Although LAE was significantly associated with the lower LA reservoir strain, the incidence of abnormal value was very low (5.2%) and indifferent between LAE and no LAE group.
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Affiliation(s)
- Jae-Hyeong Park
- Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Chungnam National University, Daejeon, Korea
| | - Kye Hun Kim
- Department of Cardiology, Chonnam National University Medical School/Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea
| | - Lawrence Rink
- International University Sports Federation (FISU), Laussane, Switzerland
| | - Kyle Hornsby
- International University Sports Federation (FISU), Laussane, Switzerland
| | - Jae Yeong Cho
- Department of Cardiology, Chonnam National University Medical School/Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea
| | - Goo-Yeong Cho
- Division of Cardiology, Department of Internal Medicine, Seoul National University and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Hwan Lee
- Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Chungnam National University, Daejeon, Korea
| | - In-Whan Seong
- Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Chungnam National University, Daejeon, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Medical School/Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea
| | - Jeong Gwan Cho
- Department of Cardiology, Chonnam National University Medical School/Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea
| | - Jong Chun Park
- Department of Cardiology, Chonnam National University Medical School/Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea
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Yoon HJ, Kim KH, Hornsby K, Park JH, Park H, Kim HY, Cho JY, Ahn Y, Jeong MH, Cho JG. Gender Difference of Cardiac Remodeling in University Athletes: Results from 2015 Gwangju Summer Universiade. Korean Circ J 2021; 51:426-438. [PMID: 33764011 PMCID: PMC8112176 DOI: 10.4070/kcj.2020.0484] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/09/2020] [Accepted: 12/24/2020] [Indexed: 01/18/2023] Open
Abstract
Background and Objectives There is little data about cardiac geometry in highly trained young athletes, especially female specific changes. We investigated gender difference on exercise induced cardiac remodeling (EICR) in highly trained university athletes. Methods A total of 1,185 university athletes divided into 2 groups; female (n=497, 22.0±2.3 years) vs. male (n=688, 22.6±2.4 years). Remodeling of the left ventricle (LV), left atrium (LA), right ventricle (RV), and any cardiac chamber were compared. Results LV, LA, RV, and any remodeling was found in 156 (13.2%), 206 (17.4%), 82 (6.9%), and 379 athletes (31.9%), respectively. LV, LA, and any remodeling were more common in male than female athletes (n=53, 12.1% vs. n=103, 15.5%, p=0.065), (n=65, 13.1% vs. n=141, 20.5%, p<0.001), (n=144, 30.0% vs. n=235, 34.2%, p=0.058), respectively, whereas RV remodeling was significantly more common in female than male athletes (n=56, 11.3% vs. n=26, 3.8%, p<0.001). Interestingly, the development of LV, LA, and RV remodeling were not overlapped in many of athletes, suggesting different mechanism of EICR according to cardiac chamber. Various predictors including sports type, heart rate, muscle mass, fat mass, body surface area, and training time were differently involved in cardiac remodeling, and there were gender differences of these predictors for cardiac remodeling. Conclusions EICR was common in both sex and was independently developed among cardiac chambers in highly trained university athletes. LV and LA remodeling were common in males, whereas RV remodeling was significantly more common in females demonstrating gender difference in EICR. The present study also demonstrated gender difference in the predictors of EICR.
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Affiliation(s)
- Hyun Ju Yoon
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Kye Hun Kim
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
| | - Kyle Hornsby
- International University Sports Federation (FISU), Lausanne, Switzerland
| | - Jae Hyeong Park
- Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Hyukjin Park
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Hyung Yoon Kim
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Yeong Cho
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Jeong Gwan Cho
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
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Shim CY. Sex Differences in Cardiac Remodeling in Athletes: Men on the Left, Women on the Right? Korean Circ J 2021; 51:439-440. [PMID: 33975388 PMCID: PMC8112183 DOI: 10.4070/kcj.2021.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/29/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- Chi Young Shim
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
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10
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Adea JEB, Leonor RML, Lu CH, Lin LC, Wu M, Lee KT, Lin YS, Chang SH, Hung KC, Lin FC, Hsieh IC, Chu PH, Wen MS, Wu VCC, Wang CL. Sport disciplines and cardiac remodeling in elite university athletes competing in 2017 Taipei Summer Universiade. Medicine (Baltimore) 2020; 99:e23144. [PMID: 33157996 PMCID: PMC7647536 DOI: 10.1097/md.0000000000023144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Cardiac remodeling is common in the athletes. Little data is available regarding the cardiac remodeling on the recently proposed 4 sport disciplines among the elite university athletes.A total of 7639 athletes participated in the 2017 Taipei Summer Universiade. Cardiac evaluation via history, ECG, and echocardiography were performed in 826 athletes who signed up for Check Up Your Heart. Athletes were grouped into one of 4 sport disciplines Skill, Power, Mixed, and Endurance.After excluding 66 participants with missing demographic data, 13 missing echocardiographic data, and 24 inadequate echocardiographic images, a total number of 723 university athletes (mean age 23 ± 3 years, 419 males) from 99 countries engaging in 25 different sporting events were analyzed. Electrocardiograms showed that Endurance group had a slower heart rate and higher percentage of left ventricular (LV) hypertrophy (39%). Echocardiograms showed there were significant differences in LV mass index (P < .001), LV geometry (P < .001), left atrial (LA) dilatation (P = .026), right ventricular (RV) dilatation (P < .001), right atrial (RA) dilatation (P < .0001), and tricuspid annular plane systolic excurse (P = .006). LV ejection fraction, LV strain, RV strain, and LV diastolic function showed no difference in 4 sport disciplines.Eccentric LV hypertrophy was the most common type of cardiac remodeling in the university athletes participated in 2017 Taipei Summer Universiade. Adaptive changes in chamber size were more commonly seen in Endurance sport. RA dilatation was the most sensitive to hemodynamic demand, followed by RV dilatation, LA dilatation, and LV dilatation.
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Affiliation(s)
- Jose-Ernesto B. Adea
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- Section of Cardiology, Makati Medical Center, Makati, Manila, Philippines
| | - Rona Marie L. Leonor
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- Section of Cardiology, Makati Medical Center, Makati, Manila, Philippines
| | - Cheng-Hui Lu
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
| | - Lung-Chun Lin
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Michael Wu
- Divison of Cardiovascular Medicine, Arrhythmia Services Section, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Kuang-Tso Lee
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Yu-Sheng Lin
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Shang-Hung Chang
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Kuo-Chun Hung
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Fen-Chiung Lin
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - I-Chang Hsieh
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Pao-Hsien Chu
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Ming-Shien Wen
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Victor Chien-Chia Wu
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Chun-Li Wang
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
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Galderisi M, Santoro C, Sorrentino R, Esposito R. Left ventricular phenotype in the athlete’s heart: what makes the difference? Eur Heart J Cardiovasc Imaging 2019; 20:387-388. [DOI: 10.1093/ehjci/jey215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
- Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Edificio 1 Via Pansini 5, Naples, Italy
| | - Ciro Santoro
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Edificio 1 Via Pansini 5, Naples, Italy
| | - Regina Sorrentino
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Edificio 1 Via Pansini 5, Naples, Italy
| | - Roberta Esposito
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Edificio 1 Via Pansini 5, Naples, Italy
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