Imaging Considerations for the Athletically Conditioned Heart: An Echocardiography-Focused Overview of the 2020 American Society of Echocardiography Recommendations on the Use of Multimodality Cardiovascular Imaging in Young Adult Competitive Athletes

Addis, Dylan R.; Townsley, Matthew M.

doi:10.1053/j.jvca.2020.06.077

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…It is well understood that cardiovascular physiological adaptations can occur due to the unique demands of regular and intense physical activity in the hearts of athletes (10). Common adaptations include enlargement of all four cardiac chambers, an increase in left ventricular (LV) wall thickness, and enhanced diastolic lling of the LV (11).…”

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confidence: 99%

Cardiac structure and function of elite Australian jockeys differs to the general population: An observational cross-sectional study.

Farley,

Bennett,

Eston

et al. 2024

Preprint

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Background The objective of this study was to compare measures of cardiac structure and function of professional jockeys to that of the general population. To determine if there are differences in heart structure and function detected using echocardiography in registered Australian jockeys when compared to the general population. It was hypothesised that remodelling of cardiac structure and function would be detected in jockeys when compared to the general population. The cardiovascular changes resulting from the physical demands of thoroughbred racing remain unexplored in this population of athletes. Australian jockeys and participants from the general population underwent two-dimensional (2D) echocardiography, which included all standard views and measurements in accordance with the American Society of Echocardiography guidelines. Each measurement was compared between groups using a Mann-Whitney U test. Results Forty-six Australian jockeys (35 ± 12 years) and thirty-three age- and gender-matched (36 ± 13 years) participants from the general population participated in this study. Jockeys were shorter (1.64 ± 0.07 vs. 1.75 ± 0.09m, p < 0.001), lighter (56.5 ± 6.0 vs. 74.2 ± 12.9kg, p < 0.001) and had a lower body surface area (BSA) (1.55 ± 0.17m2 vs.1.9 ± 0.2m2, p < 0.001). Jockeys had a larger absolute left ventricular (LV) end diastolic volume (LVEDV) than the control group (120 ± 18.2 ml vs.109.3 ± 29.0 ml, p = 0.05) which had a larger variation when indexed for BSA (78.0 ± 12.2 ml/m2 vs. 57.5 ± 13.3 ml/m2, p < 0.001). Absolute LV mass did not differ between groups (123.8 ± 36.7g vs 124.2 ± 35.3g, p = 0.92), however jockeys demonstrated higher LV mass index (79.4 ± 18.1g/m2 vs 65.2 ± 15.4g/m2, p < 0.001). Both groups demonstrated clinically normal LV ejection fraction (LVEF) with jockeys being slightly higher, but not clinically different (60.8 ± 5.2% vs. 57 ± 3%, p < 0.001). Despite this, stroke volume (SV) was lower for jockeys than the control group (64.1 ± 12.6mL vs 75.7 ± 20.7mL), however, when indexed for BSA differences were not significant (p = 0.32). Left atrial volume index (LAVi) was larger in jockeys (33.4 ± 6.5mL/m2 vs. 26.3 ± 7.0mL/m2, p < 0.001). There were no differences in global longitudinal strain (GLS) (-19.3 ± 3.0 vs. -19.8 ± 1.6%, p = 0.52). Conclusions Jockeys have a distinct cardiac structure and function compared to the general population. Differences are attributed to chronic physiological demands of racing and should be considered in future research involving jockeys and by practitioners working with jockey athletes.

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Cardiac structure and function of elite Australian jockeys differs to the general population: An observational cross-sectional study.

Farley,

Bennett,

Eston

et al. 2024

Preprint

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High Prevalence of Pericardial Involvement in College Student Athletes Recovering From COVID-19

Brito

Meester

Yanamala

et al. 2021

JACC: Cardiovascular Imaging

188

290

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Objectives We sought to explore the spectrum of cardiac abnormalities in student-athletes who returned to university campus in July 2020 with an uncomplicated Coronavirus disease 2019 (COVID-19). Background There is limited information regarding cardiovascular involvement in young individuals with mild or asymptomatic COVID-19. Methods Screening echocardiograms were performed in 54 consecutive student-athletes (mean age: 19 years, 85% males) who tested positive on reverse transcription–polymerase chain reaction nasal swab testing of the upper respiratory tract or IgG antibodies against SARS-CoV-2. A sequential cardiac magnetic resonance (CMR) imaging was performed in 48 (89%) subjects. Results A total of 16 (30%) athletes were asymptomatic while 36 (66%) and 2 (4%) reported mild and moderate COVID-19 related symptoms, respectively. For the 48 athletes completing both imaging studies, abnormal findings were identified in 27 (56.3%) individuals. This included 19 (39.5%) showing pericardial late enhancements with associated pericardial effusion. Of the individuals with pericardial enhancements, 6 (12.5%) had reduced global longitudinal strain (GLS) and/or an increased native T1. One patient showed myocardial enhancement and reduced left ventricular ejection fraction or reduced GLS with or without increased native T1 were also identified in additional 7 (14.6%) individuals. Native T2 were normal in all subjects and no specific imaging features of myocardial inflammation were identified. Hierarchical clustering of LV regional strain identified three unique myopericardial phenotypes that showed significant association with the CMR findings (P=0.03). Conclusion Over one in three previously healthy college-athletes recovering from COVID-19 infection showed imaging features of a resolving pericardial inflammation. Although subtle changes in myocardial structure and function were identified, no athlete showed specific imaging features to suggest an ongoing myocarditis. Further studies are needed to understand the clinical implications and long-term evolution of these abnormalities in uncomplicated COVID-19.

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Perioperative Implications of the 2020 American Heart Association/American College of Cardiology Guidelines for the Diagnosis and Treatment of Patients with Hypertrophic Cardiomyopathy: A Focused Review

Addis

Townsley

2022

Journal of Cardiothoracic and Vascular Anesthesia

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Imaging Considerations for the Athletically Conditioned Heart: An Echocardiography-Focused Overview of the 2020 American Society of Echocardiography Recommendations on the Use of Multimodality Cardiovascular Imaging in Young Adult Competitive Athletes

Cited by 4 publications

References 19 publications

Cardiac structure and function of elite Australian jockeys differs to the general population: An observational cross-sectional study.

Cardiac structure and function of elite Australian jockeys differs to the general population: An observational cross-sectional study.

High Prevalence of Pericardial Involvement in College Student Athletes Recovering From COVID-19

Perioperative Implications of the 2020 American Heart Association/American College of Cardiology Guidelines for the Diagnosis and Treatment of Patients with Hypertrophic Cardiomyopathy: A Focused Review

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