Redefining the upper limits of ventricular volumes in elite athletes

Abstract Background/Introduction Specific athlete reference values for cardiac volumes and function using magnetic resonance (CMR) parameters have been reported are used in clinical practice. Elite athletes conventionally thought to demonstrate the highest levels of physiological adaptation sports therefore dictate upper limit normal biventricular size population. Purpose To compare volumetric a cohort both male female elite-level previously published values. Methods We data from prospective ELITE-cohort, which collects pre-participation elite (national-, international-, Olympic-, Paralympic-level), including CMR imaging. Athletes suspected pathology based on comprehensively investigated electrocardiograph, exercise test, echocardiogram late gadolinium enhancement were excluded. Biventricular derived short-axis cine images Cvi42 (v5.1.2.) indexed body surface area (BSA). Volumetric compared gender- Mitchell classification specific 95th percentile (95%tile) values, as by Luijkx et al.: left-ventricle (LV) end-diastolic volume (EDV) / BSA high-static high-dynamic (HS/HD; ♀ 142 ♂ 158); low-static (LS/HD; 127 149); low-dynamic (HS/LD; 114 140); right ventricle (RV) EDV HS/HD (♀ 154 184), LS/HD 136 163), HS/LD 120 157). Results analysed total 221 (38% female), with median age (IQR) 26.0 (22.5–29.8) years, mean ±SD 1.96±0.22 m2. classified according classification: 116 (54%); 61 (29%); moderate-static (MS/HD) 20 (9.4%); 16 (7.5%) (Table). found smaller RV EDV/BSA participating (♀: 117±20 (148) ♂: 133±20 (160)) 109±11 (129) 119±15 (142)) LV (116±15 (138)) (Figure). When conventional cut-offs our population we 10 (4.5%) 2 (0.9%) above 95%tile LVEDV/BSA RVEDV/BSA, respectively Conclusion In consisting healthy, athletes, adaptations less outspoken current ranges, specifically RV. Only 1 percent exceeded references Potentially, could overestimate healthy limits athletes. Our study indicate that stricter definition 95%tile, might be added value group help differentiate between adaptation. Funding Acknowledgement Type funding sources: Public grant(s) – National budget only. Main source(s): Amsterdam Movement Sciences (P1A210AMC2018)