Lithuanian Atletes' Aortic Diameter
Condition: Sports Accident; Athletes Heart
Study type: Observational

Summary: 
      Recent developments in football have seen the sudden death of young football player due to
      aortic rupture hence reinforcing the controversy of football as a field with substantial risk
      for sudden cardiac arrest and death. Moreover, there is an argument that aortic dilatation
      and the subsequent event of thoracic aortic aneurysm may be an occupational disease due to
      the nature of some vocations (i.e., military and security personnel, blue collar workers,
      weightlifters, athletes etc.). Of particular importance, there is some evidence that elite
      athletic training is associated with small but significantly larger aortic root diameter. The
      purpose of this study was to investigate aortic root adaptation to physical workload and to
      determine if aortic root's and left ventricle sizes are contingent upon the physical workload
    

Detailed description: 
      A preliminary data was collected from a total of 944 subjects in Kaunas Sports Medicine
      Centre during the recruiting period in 2014-2015. Final data analysis consisted of 151
      Caucasian subjects who met the inclusion criteria.

      All subjects underwent two-dimensional (2D) transthoracic echocardiography (TTE) procedure.
      Prior to performing 2D TTE, subjects' arterial blood pressure, heart rate, height, weight,
      and self-reported physical activity levels were measured.

      The Ultrasound system CX50 (Philips Ultrasound, Philips Healthcare, Philips Medical Systems
      Nederland, USA) - with transducer S5-1 was used in this study. Two physicians performed 2D
      TTE and averages for all variables of interest were computed. The measurements of aortic root
      and the left ventricle were drawn upon the guidelines of the American Society of
      Echocardiography and the European Association of Cardiovascular Imaging.

      The maximal diameter of the sinuses of Valsalva was measured at end-diastole, in a strictly
      perpendicular plane to that of the long axis of the aorta using the edge to leading edge
      (L-L) convention. The aortic annulus was measured at midsystole from inner edge to inner edge
      (I-I). This was done in order to obtain the rounder shape and bigger diameter of aortic
      annulus.
    

Intervention name(s): Physical load
Intervention type(s): Other
Intervention description(s): The impact of training on cardiac structure and function depends on the type, intensity and duration of the activity, as well as previous physical activity engagement, genetics and gender type. More knowledge about cardiac pathophysiologic training adaptation is needed.
Observational model: Ecologic or Community
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        The subjects were divided into groups according to gender (i.e., female, male), physical
        activity (i.e., athletes, non-athletes) and physical activity type (i.e., strength and
        endurance sports). Of the 151 subjects, 122 were athletes (41 females and 81 males) and 29
        were non-athletes (14 females and 15 males). Of the 41 female athletes, 32 were endurance
        athletes, and 9 strength athletes. From 81 male athletes, 56 were endurance athletes, and
        25 were strength athletes.
      
Keywords: Aortic Valve; Sinus of Valsalva; Echocardiography; Sudden cardiac death