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Indications, protocols, and interpretation of cardiovascular imaging for the evaluation and management of athletes: a clinical consensus statement of the European Association of Preventive Cardiology (EAPC) and the European Association of Cardiovascular Imaging (EACVI) of the ESC: Part 1-Exercise imaging.

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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Aortic root dilatation in athletic population.

Antonio Pelliccia1, Fernando M Di Paolo, Filippo M Quattrini

  • 1Institute of Sport Medicine and Science, Italian National Olympic Committee, Rome, Italy. ant.pelliccia@libero.it

Progress in Cardiovascular Diseases
|March 6, 2012
PubMed
Summary

Athletic training can cause mild aortic root remodeling, particularly in endurance athletes. Some athletes exceed normal limits, requiring monitoring for potential aortic dilatation.

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Published on: June 29, 2014

Area of Science:

  • Cardiovascular Physiology
  • Sports Medicine
  • Diagnostic Imaging

Background:

  • Aortic root remodeling is expected in athletes due to exercise-induced hemodynamic overload.
  • Limited data exist on the prevalence and extent of this remodeling in athletic populations.
  • Understanding physiological limits is crucial for differentiating training effects from pathology.

Purpose of the Study:

  • To review current knowledge on aortic remodeling in athletes.
  • To define prevalence, upper limits, and clinical significance of exercise-induced aortic changes.
  • To guide clinical evaluation of athletes with aortic root enlargement.

Main Methods:

  • Review of existing literature on aortic dimensions in athletes and non-athletes.
  • Analysis of data from large athletic cohorts and specific discipline impacts.
  • Establishment of sex-specific upper limits for aortic root diameter.

Main Results:

  • Exercise training has a modest effect on aortic dimensions, with endurance sports showing mild increases.
  • Power disciplines have minimal impact on aortic size.
  • The 99th percentile for aortic root diameter is approximately 40 mm (males) and 34 mm (females), considered physiologic upper limits.

Conclusions:

  • While mild aortic remodeling occurs in athletes, a small percentage exceed physiologic limits without systemic disease.
  • Athletes with aortic enlargement may experience further dilatation, necessitating monitoring.
  • Serial echocardiographic evaluations are recommended for athletes with aortic root dimensions exceeding sex-specific thresholds.