Several studies suggest sex-differences in ventricular dimensions in athletes. Few studies have, however, made comparisons of data indexed for lean body mass (LBM) using allometry. Ninety Caucasian college athletes (mixed-sports) who were matched for age, ethnicity and sport total cardiovascular demands, underwent Dual Energy X-Ray Absorptiometry (DEXA) scan for quantification of LBM. Athletes underwent comprehensive assessment of left and right ventricular and atrial structure and function using 2D echocardiography as well as deformation imaging using the TOMTEC analysis system. The mean age of the study population was 18.9±1.9 years. Female athletes (n=45) had a higher fat free percentage (19.4±3.7%) compared to male athletes (11.5±3.7%). When scaled to body surface area (BSA), male had on average 19±3% (P< 0.001) higher LV mass; in contrast when scaled to LBM there was no significant difference in indexed LV mass -1.4 ± 3.0% (P=0.63). Similarly, when allometrically scaled to LBM, there was no significant sex-based difference in LV or left atrial volumes. Although female athletes had mildly higher LV ejection fraction (EF) and LV global longitudinal strain in absolute value, systolic strain rate and allometrically indexed stroke volume (SV) were not different between sexes (1.5±3.6% (P=0.63) and 0.0±3.7% (P=0.93) respectively). There were no differences in any of the functional atrial indices including strain or strain rate parameters. In conclusion, sex related differences in ventricular dimensions or function (stroke volume) appear less marked, if not absent, when indexing using LBM allometrically.Key words: Athletics, Ventricular Remodeling and Function, Atrial remodeling, Lean body mass, Deformation imaging, echocardiographyDespite several years of investigation, the extent of sex differences in ventricular dimension and function in athletes remains a subject of debate. [1][2][3][4][5][6][7][8][9][10][11] Part of the controversy may be related to the fact that only few studies took into account body composition when scaling cardiac dimensions. In this study, we sought to determine, in college athletes, whether sex-related differences in ventricular dimensions persisted after adjustment for lean body mass (LBM). In second intention, we sought to compare sex associated differences in functional parameters including ventricular and atrial strain analysis.
MethodsIn 2008, 315 Caucasian college athletes were included in the pre-season cardiac screening process at Stanford University using the AHA-12 point questionnaire, ECG and a screening echocardiogram. Of these participants, 124 volunteered to undergo Dual Energy X-Ray Absorptiometry (DEXA) for assessment of body composition. Of these subjects, we selected 90 (45 male, 45females) were matched according to age, ethnicity/race and total cardiovascular demand. 12 We excluded subjects who participated in sports in high dynamic and static component such as rowing, cycling and triathlon as these were asymmetrically distributed among sexes. 12 The sports di...