title: Left ventricular remodeling and the athlete's heart, irrespective of quality load training.
abstract: BACKGROUND
  Regular physical exercise determines a progressive increase of the cardiac mass known as adaptive hypertrophy. Up to now, two morphological echocardiographic heart patterns of athletes have been described by Morganroth in 1975: predominant augmentation of wall thickness, and major cavity size in chamber dimensions in the case of prevalent static or dynamic components. The aim of the study was to follow up the impact of physical training on heart morphology and function in a group of elite soccer and rugby players for at least five years.
  
  
  METHODS
  From January 1993 to December 2015 a group of 250 elite soccer players and 114 rugby players were examined: 78 soccer players and 60 rugby players were followed up for 5 years. They were matched with a control group.
  
  
  RESULTS
  LV dimensions and LVMi were significantly higher in the athletes than in the inactive subjects (LVMi : 123.45; LVMi: 81.5 vs 94.36 g/m2 respectively). After the five-year follow up the athletes showed no significant modifications in cardiac dimensions: (LVDd from 52.00 ± mm to 52.90 ± mm; LVSd increased from 31.58 ± mm to 32.33 ± mm; Left Ventricular CMI from 120.77 to 121.45 g/m2;p = NS in soccer; from 50.43 ± mm to 52.22 ± mm; Left Ventricular Systolic diameter increased from 32.51 ± mm to 32.8 ± mm; Left Ventricular Mass index from 81,5 to 87,4 g/m2;p = NS and no significant enhancement of the aortic root diameter was observed (Aortic root: from 27.39 mm to 31.64 mm in soccer players; from 30,68 mm to 30.95 mm).
  
  
  CONCLUSIONS
  No significant differences were found among the athletes practicing sports with different workload components, and resistance training. In trained athletes the dimensions of the LV chamber and LVMi are generally within the upper limits of the normal range. After a five-year follow-up, the dimensions of the chambers of the heart remain within the normal range, despite being within the the upper limits. Regular physical exercise induces mild LV hypertrophy which therefore can be considered an adaptive consequence to stress-exercise.
authors.affiliation: Department of Experimental and Clinical Medicine Sport Medicine and Exercise Unit, University of Florence, AOU Careggi-Italy, Via delle Oblate 5, Florence, Italy. giorgio.galanti@unifi.it.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Galanti
authors.affiliation: Department of Experimental and Clinical Medicine Sport Medicine and Exercise Unit, University of Florence, AOU Careggi-Italy, Via delle Oblate 5, Florence, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Stefani
authors.affiliation: Department of Experimental and Clinical Medicine Sport Medicine and Exercise Unit, University of Florence, AOU Careggi-Italy, Via delle Oblate 5, Florence, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Mascherini
authors.affiliation: Department of Experimental and Clinical Medicine Sport Medicine and Exercise Unit, University of Florence, AOU Careggi-Italy, Via delle Oblate 5, Florence, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Di Tante
authors.affiliation: Department of Experimental and Clinical Medicine Sport Medicine and Exercise Unit, University of Florence, AOU Careggi-Italy, Via delle Oblate 5, Florence, Italy.
authors.forename: Loira
authors.initials: L
authors.lastname: Toncelli
mesh_terms: D000328:Adult; D056352:Athletes; D004452:Echocardiography; D005500:Follow-Up Studies; D005538:Football / Q000502:physiology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D012016:Reference Values; D012916:Soccer / Q000502:physiology*; D013997:Time Factors; D020257:Ventricular Remodeling / Q000502:physiology*; D055815:Young Adult
keywords: Athlete’s hearth; Echocardiography; Sports activity