Prevalence and Progression of Aortic Root Dilatation in Highly Trained Young Athletes

Professor Sharma and his team from London investigated the prevalence of an enlarged aorta in 3781 British athletes and 806 control individuals. The mean age was 19 ± 5.9 years, and 63.3% were male. The average time of training was 16.7 hours per week. The follow-up lasted for 5 ± 1.5 years.
This study found that athletes had a slightly larger aortic diameter compared to controls (28.3 ± 4.1 versus 27.8 ± 4.1 mm; p=0.01), but this difference was only 0.9 mm. The 99th percentile value for the aortic diameter in men and women was 40 mm and 38 mm, respectively, which represent an enlarged aortic diameter. The aortic diameter did not exceed 43 mm in any man or 41 mm in any woman. Five men and 6 women had an enlarged aortic diameter. These 11 athletes were followed for more than 5 years with serial echocardiograms and continued to exercise during that period. No progressive enlargement in the aortic diameter was observed in this group of athletes.
In conclusion, a small minority of athletes (0.3%) had a slightly enlarged aorta. The aortic diameter rarely exceeded 40 mm in men or 38 mm in women. Medium-term follow-up revealed no evidence of progressive enlargement of the aortic diameter in those athletes with an enlarged aorta.