Atrial Adaptations in Athletes Heart

Area of Science:

• Cardiology
• Sports Medicine
• Exercise Physiology

Background:

• Intensive training causes hemodynamic changes, increasing cardiac output and stroke volume, enhancing athletic performance.
• These adaptations can lead to cardiac chamber enlargement, including the atria, potentially resulting in athletes' heart (AH).
• Limited large-scale data exists on atrial enlargement in athletes' heart conditions.

Purpose of the Study:

• To investigate the prevalence and characteristics of atrial enlargement in competitive athletes.
• To determine the association between athletes' heart (AH) and cardiac chamber dimensions, specifically left ventricular mass and atrial areas.

Main Methods:

• Included 646 competitive athletes (≥18 years) undergoing pre-participation screening between April 2020 and October 2021.
• Stratified athletes based on the definition of athletes' heart (AH): physiological heart volume >13.0 mL/kg (males) or >12.0 mL/kg (females).
• Analyzed computed absolute heart volume, left ventricular mass, left atrial (LA) area, and right atrial (RA) area.

Main Results:

• 18.3% of athletes (118 out of 646) exhibited athletes' heart (AH).
• Athletes with AH showed significantly larger heart volumes (969.4 mL vs. 841.3 mL), left ventricular mass (206.6 g vs. 182.7 g), LA area (15.4 cm² vs. 14.3 cm²), and RA area (15.8 cm² vs. 14.5 cm²).
• Logistic regression confirmed AH as an independent predictor for increased LV mass, LA area, and RA area.

Conclusions:

• Athletes' heart (AH) is associated with significant enlargement of the atria (both left and right).
• Increased cardiac muscle mass, particularly left ventricular mass, is a key feature accompanying athletes' heart.
• These findings highlight the cardiac remodeling that occurs in response to intensive athletic training.