In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Normative reference values for the right ventricle in competitive athletes.

Session Sports cardiology: adaption or disease

Speaker Assistant Professor Flavio D'Ascenzi

Event : ESC Congress 2017

  • Topic : preventive cardiology
  • Sub-topic : Sports Cardiology
  • Session type : Moderated Posters

Authors : F D'ascenzi (Siena,IT), M Solari (Siena,IT), F Loiacono (Siena,IT), S Caselli (Rome,IT), M Focardi (Siena,IT), A Pelliccia (Rome,IT), M Bonifazi (Siena,IT), S Mondillo (Siena,IT)

F. D'Ascenzi1 , M. Solari1 , F. Loiacono1 , S. Caselli2 , M. Focardi1 , A. Pelliccia2 , M. Bonifazi3 , S. Mondillo1 , 1University of Siena, Department of Medical Biotechnologies, Division of Cardiology - Siena - Italy , 2Institute of Sport Medicine and Science CONI - Rome - Italy , 3University of Siena, Department of Medicine, Surgery, and NeuroScience - Siena - Italy ,

European Heart Journal ( 2017 ) 38 ( Supplement ), 830-831

Background: Training-induced right ventricular (RV) enlargement is frequent in athletes. Unfortunately, RV dilatation is also a common phenotypic expression and one of the diagnostic criteria of arrhythmogenic RV cardiomyopathy (ARVC). The current echocardiographic reference values derived from the general population can overestimate the presence of RV dilatation and/or dysfunction in competitive athletes.

Purpose: We performed a meta-analysis of the literature to derive the proper reference values for assessing RV enlargement in competitive athletes.

Methods: We conducted systematic review of English-language studies in MEDLINE, Scopus, and Cochraine databases from inception to April 2016, investigating the RV by echocardiography in competitive athletes.

Results: 7,287 competitive athletes were included in the final analysis. The mean value of RV echocardiographic parameters was reported both for male and female athletes. Reference values for RV functional and dimensional parameters were established for male athletes and reported separately when age and type of sports significantly had an impact. Male competitive athletes exhibited a marked RV remodelling with the upper limits of normality being greater than those recommended for the general population, particularly for absolute dimensional parameters. The upper limits of RV outflow tract (RVOT) indexes (RVOT PLAX 18 mm/m2; RVOT PSAX 22 mm/m2) and the lower limit of RV fractional area change (38% for athletes under 30-years-old and 33% for athletes over 30-years -old) were similar to those recommended by current Task Force as major diagnostic criteria for ARVC. The lower limit of RV strain was similar to that recommended for the general population, i.e. -21%.

Conclusions: Physicians should be aware that application of the current recommendations for normal population could be misleading when evaluating athletes. In this meta-analysis we derive normative values for RV echocardiographic examination to be applied in competitive athletes exhibiting RV remodelling. We suggest using these normative reference values to avoid the overestimation of RV abnormal size or function in this specific population.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are