Longitudinal cardiac remodeling in collegiate American football players as assessed by echocardiography during their collegiate career

Clin Cardiol. 2023 Sep;46(9):1090-1096. doi: 10.1002/clc.24121. Epub 2023 Aug 13.

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.

Keywords: athlete; cardiac remodeling; echo; football.

MeSH terms

  • Adult
  • Atrial Fibrillation*
  • COVID-19*
  • Echocardiography / methods
  • Football*
  • Heart Atria / diagnostic imaging
  • Humans
  • Ventricular Remodeling
  • Young Adult