Scaling cardiac dimensions to body size is crucial in the cardiovascular care of elite athletes

As part of their systematic review and meta-analysis, the authors emphasize the impact of body surface area on athletes heart (1). They underline the critical importance of reporting anthropometrics and/or appropriately scaled data in future studies, but conclude that this approach to analysis is unfortunately rare. We like to refer the interested reader to our recent comprehensive analysis of the influence of various ratiometrically and allometrically scaled body size variables such as body surface area, fat-free mass and height on left ventricular dimensions in athletes (2). This study provides gender-specific echocardiographic data of 1051 healthy adult elite athletes with a mean training history of 10 years separated by low-, moderate- and high-dynamic disciplines, the latter of which is also compared to an age-matched sedentary control group. Appropriate allometric scaling of left ventricular dimensions eliminated some of the absolute between-group differences in cardiac dimensions, but in male high-dynamic athletes cardiac size exceeded a sole influence of body size. The strongest association between a body size variable and left ventricular dimensions was found for fat-free mass. We therefore agree with the authors that cardiac dimensions in elite athletes are substantially influenced by body size. Appropriate scaling should be a routine part of the cardiovascular care of elite athletes as it sheds more light on the "gray area" between physiologic cardiac adaptations to exercise and cardiomyopathy.

References

1. Utomi V, Oxborough D, Whyte GP, et al. Heart Published Online First: March 9, 2013 doi:10.1136/heartjnl-2012-303465

2. Pressler A, Haller B, Scherr J, et al. Association of body composition and left ventricular dimensions in elite athletes. Eur J Prev Cardiol 2012;19:1194-204

Conflict of Interest:

None declared