title: Prevalence and clinical significance of aortic root dilation in highly trained competitive athletes.
abstract: BACKGROUND
  Few data are available that address the impact of athletic training on aortic root size. We investigated the distribution, determinants, and clinical significance of aortic root dimension in a large population of highly trained athletes.
  
  
  RESULTS
  Transverse aortic dimensions were assessed in 2317 athletes (56% male), free of cardiovascular disease, aged 24.8+/-6.1 (range, 9 to 59) years, engaged in 28 sports disciplines (28% participated in Olympic Games). In males, aortic root was 32.2+/-2.7 mm (range, 23 to 44; 99 th percentile=40 mm); in females, aortic root was 27.5+/-2.6 mm (range, 20 to 36; 99 th percentile=34 mm). Aortic root was enlarged >or=40 mm in 17 male (1.3%) and >or=34 mm in 10 female (0.9%) subjects. Over an 8-year follow-up period, aortic dimension increased in these male athletes (40.9+/-1.3 to 42.9+/-3.6 mm; P<0.01) and dilated substantially (to 50, 50, and 48 mm) in 3, after 15 to 17 years of follow-up, in the absence of systemic disease. Aortic root did not increase significantly (34.9+/-0.9 to 35.4+/-2.1 mm; P=0.11) in female athletes. Multiple regression and covariance analysis showed that aortic dimension was largely explained by weight, height, left ventricular mass, and age (R(2)=0.63; P<0.001), with type of sports training having a significant but lower impact (P<0.003).
  
  
  CONCLUSIONS
  An aortic root dimension >40 mm in highly conditioned male athletes (and >34 mm in female athletes) is uncommon, is unlikely to represent the physiological consequence of exercise training, and is most likely an expression of a pathological condition, mandating close clinical surveillance.
authors.affiliation: Institute of Sports Medicine and Science, Largo Piero Gabrielli, 1, 00197 Rome, Italy. ant.pelliccia@libero.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Pelliccia
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Di Paolo
authors.forename: Elvira
authors.initials: E
authors.lastname: De Blasiis
authors.forename: Filippo M
authors.initials: FM
authors.lastname: Quattrini
authors.forename: Cataldo
authors.initials: C
authors.lastname: Pisicchio
authors.forename: Emanuele
authors.initials: E
authors.lastname: Guerra
authors.forename: Franco
authors.initials: F
authors.lastname: Culasso
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Maron
mesh_terms: D000293:Adolescent; D000328:Adult; D001021:Aortic Valve / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000502:physiology*; D056352:Athletes; D054874:Athletic Performance / Q000502:physiology*; D002648:Child; D004562:Electrocardiography; D015444:Exercise / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014463:Ultrasonography; D055815:Young Adult