Abstract 15169: Echocardiographic Reference Values of the Aortic Root Dimensions in Elite Athletes

Introduction: The diagnosis of aortic (Ao) disorders in athletes is complicated by the belief that prolonged and intense exercise training may induce Ao enlargement as a physiological response. There are few studies with a large population of elite athletes (EA) regarding the effects of training on the aorta (Ao). This study was designed to establish the physiological limits of Ao remodeling associated to exercise training. Hypothesis: Since exercise training in EA could induce Ao remodeling, normal Ao dimensions could be greater in EA than in the general population. Method: Cross-sectional study including 4,267 healthy Spanish EA. All of them completed subsequently a minimal follow-up of 4 years without developing any event that precluded them to continue in high competition. There were 1,520 women (age 20.3±5.4 y, BSA 1.65±0.18 m2, 7.7±4.3 years/training and 19.6±10.6 hours/day of training) and 2,742 men (age 22.2±6.2 y, BSA 1.93±0.22 m2, 8.6±5 years/training and 18.9±8.8 hours/day of training). They were categorized into 3 groups according to the dynamic component of Mitchell`s classification (A=Low, B=Moderate, and C=High) and underwent transthoracic echocardiography. The end-diastolic Ao diameters were measured in the parasternal long axis at Ao annulus (AA), sinus of Valsalva (SV), sinotubular junction (SJ), and the maximum diameter of the proximal ascending Ao (Aspx). Results: Table 1 shows Ao measurements corrected by BSA, according to sex and dynamic component of the Mitchell`s classification (P95= percentile 95). Two men had an Ao diameter greater than 40 mm at AA (0.1%), 38 at SV (1.8%), 3 at SJ (0.1%) and 6 at Aspx (0.3%). Fourteen women had an Ao diameter greater than 34 mm at SV (1.1%) and 2 at Aspx (0.1%). Conclusions: Mean diameters of Ao root in healthy EA are within the normal range for the general population both in absolute numbers and after correction for BSA at all levels of dynamic training. These values may be used as a reference to rule out Ao disease in EA.