Echocardiographic assessment of cardiac remodeling in the high-level football player

Introduction: The aim of this study is to assess the morphological and hemodynamic cardiovascular changes of 24 high-level football players, using Doppler-echocardiography, and compare them to a similar control group. Methods and results: Twenty-four elite football players were matched to 24 normal subjects according to age, sex, and body surface. All participants had a clinical examination, resting ECG, Doppler-echocardiography and a measurement of maximal oxygen uptake (VO2 max). The echocardiographic variables were compared between two groups by the Student's t-test and other statistical tests, using the SPSS 12 for Windows software. Compared to the control group, the wall thickness (10.49+1.04 vs. 7.5+2.04 mm, p<0.05), the LV end-diastolic diameter (57.1+3.70 vs. 41.2+3.65 mm, p<0.01) and left atrium surface (20.16+2.03 vs. 16.16+1.83 cm2, p<0.01) were significantly more important in football players. The LV and RV ejection fractions were similar in both groups. The RV long-axis diastolic diameter (8+0.5 vs. 6.5+1.1 mm, p<0.01) and S-wave using DTI (0.17+0.02 vs. 0.14+0.02, p<0.05) were more important among football players. Discussion: The hemodynamic and morphological changes result from an acquired cardiac adaptation in athletes with important endurance and resistive efforts. The majority of players presented an intermediate-type of remodeling, but the more offensive ones had an endurance-type heart, whereas the defense players had a resistance-type aspect. Conclusion: This study on the cardiac remodeling in high-level athletes permits to have a distinctive approach between physiological and pathological remodeling. This remodeling varies according to the player's post and exercise capacities. In a football player, a correlation between physical level and physical capacity is plausible.