Oral Abstract Session: Epidemiology and sports cardiology

295 Prevalence and clinical significance of aortic root dilatation in highly-trained, competitive athletes B Di Giacinto, E De Blasiis, FM Di Paolo, FM Quattrini, C Pisicchio, E Guerra, R Ciardo, A Pelliccia Institute of Sport Medicine and Science, CONI, Rome, Italy Topic: Sports cardiology Purpose: Prevalence, clinical significance, and long-term consequences of aortic root (AoR) dilatation in competitive athletes are not yet investigated. Our aim was to assess the distribution and determinants of AoR size in a large population of competitive athletes. Methods: AoR dimension were assessed by echocardiography in 2,361 athletes participating in 48 different sports. Of them, 44 were excluded because aortic structural abnormalities, such as bicuspid aortic valve, Marfan s Syndrome, aortic prosthesis. The remaining 2,317, including 1,300 (56%) males and 1,017 (44%) females were the study population. Arbitrary cut-off of =40 mm, according to #36th Bethesda Conference, was used as upper normal limits for AoR. Results: In males AoR was 32.2 2.7 mm (range 23-44) and the 95th percentile was 37 mm. In females AoR was 27.5 2.6 mm (20-36) and the 95th percentile was 32 mm.Multiple regression and covariance analysis showed AoR dimension largely explained by body surface area, left ventricular mass and age (R21⁄4 0.61), with type of sports participation having only a modest effect. The AoR was<40 mm in 2,300 athletes (99%), and = 40 mm in only 17 (1%), all male. In this subset, aortic dimension increased over a 8 5 year follow-up (40.9 1.3 to 42.9 3.6 mm; p <0.01), including 3 former athletes in whomAoR become dilated (to 50mm, 50mm and 48mm) after 15-16 years, in the absence of symptoms or evidence of systemic disease. Conclusion:Dilatation of the aortic root ( =40 mm) is rare in highly trained athletes and is not a consistent feature of‘‘athlete s heart’’. Longitudinal assessment in athletes with AoR =40 mm showed further dimensional increase, which occasionally was very marked. Selective restriction from most intense competitive sports may be indicated in these athletes to reduce the risk associated with accelerated aortic enlargement.