Echocardiographic Assessment of Left Ventricular Remodeling in American Style Footballers

Int J Sports Med. 2020 Jan;41(1):27-35. doi: 10.1055/a-1014-2994. Epub 2019 Dec 2.


Several athletic programs incorporate echocardiography during pre-participation screening of American Style Football (ASF) players with great variability in reported echocardiographic values. Pre-participation screening was performed in National Collegiate Athletic Association Division I ASF players from 2008 to 2016 at the Division of Sports Cardiology. The echocardiographic protocol focused on left ventricular (LV) mass, mass-to-volume ratio, sphericity, ejection fraction, and longitudinal Lagrangian strain. LV mass was calculated using the area-length method in end-diastole and end-systole. A total of two hundred and thirty players were included (18±1 years, 57% were Caucasian, body mass index 29±4 kg/m2) after four players (2%) were excluded for pathological findings. Although there was no difference in indexed LV mass by race (Caucasian 78±11 vs. African American 81±10 g/m2, p=0.089) or sphericity (Caucasian 1.81±0.13 vs. African American 1.78±0.14, p=0.130), the mass-to-volume ratio was higher in African Americans (0.91±0.09 vs. 0.83±0.08, p<0.001). No race-specific differences were noted in LV longitudinal Lagrangian strain. Player position appeared to have a limited role in defining LV remodeling. In conclusion, significant echocardiographic differences were observed in mass-to-volume ratio between African American and Caucasian players. These demographics should be considered as part of pre-participation screening.

MeSH terms

  • Adolescent
  • Black or African American
  • Body Composition / physiology
  • Echocardiography
  • Football / physiology*
  • Heart Ventricles / anatomy & histology
  • Heart Ventricles / diagnostic imaging*
  • Humans
  • Male
  • Race Factors
  • Retrospective Studies
  • United States
  • Ventricular Remodeling / physiology*
  • White People
  • Young Adult