ESC Congress This year, the European Society of Cardiology conference was held in Paris, France. It was an excellent opportunity for the CRY doctors and researchers to address new evidence and studies in the field of sports cardiology and in the prevention of sudden cardiac death. Professor Sanjay Sharma focussed on the use of imaging and its role with a talk entitled: “Should imaging be part of the cardiovascular evaluation of middle-aged individuals?”. He also spoke on “Cardiac magnetic resonance for identification of athletes at risk”.
Keteepe-Arachi (left) presented her poster and abstract on “Hypertension or hypertrophic cardiomyopathy? Using cardiovascular magnetic resonance imaging to unmask the great imitator”. The conference was highly informative and continues to demonstrate the importance of CRY’s research.
EuroPrevent The EuroPrevent 2019 conference was held in Lisbon, Portugal in April, and CRY was well-represented by many current and former Research Fellows. Those giving presentations included Dr Harshil Dhutia (“Syncope in an athlete; Listen to the story!”), Dr Aneil Malhotra (“Choose the right pacemaker for the right athlete”), Dr Gherardo Finocchiaro (“Interpret diastolic function in an athlete”) and Dr Sabiha Gati (“Sports after myocarditis”). CRY doctors also gave a range of poster presentations, including Dr Bashar Ibrahim (“Aortic root remodeling in life long veteran endurance athletes”), Dr Malhotra (“Efficacy of the international recommendations in adolescent athletes”), Dr Hamish MacLachlan (“Additional yield and challenges of transthoracic echocardiography as a first-line screening tool; experience from a national cardiac screening programme in elite cricketers”), and Dr Gemma Parry-Williams (“The short PR interval in young athletes”).
Continuing with the imaging theme, CRY Fellow Dr Tracey
Professor Sanjay Sharma also attended and gave a talk on how to plan medical services for mass participation events.
Interview with Dr Sabiha Gati In this interview Dr Sabiha Gati discusses her research on aortic root dilatation in young athletes and how the condition can be managed (“Prevalence and progression of aortic root dilatation in highly trained young athletes.” Gati S, Malhotra A, Sedgwick C et al. Heart, June 2019).
How did you conduct your study? Aortic root enlargement is reported in young people and athletes; however, it is unclear whether these changes are due to intensive physical activity or represent a potentially serious condition that may cause sudden cardiac death. Between 2003 and 2015, we conducted an observational study collecting echocardiography data (ultrasound of the heart) on athletes aged 14-35 years old to identify individuals with an enlarged aorta which is the main vessel that leaves the heart called the aorta (figure 1). We had screened 3,781 young athletes who trained for an average of 17 hours per week and compared
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Research Highlights 2019
them with 806 young sedentary volunteers who were recruited from a population screening programme offered by CRY. These individuals were subsequently followed up for approximately 7 years. What were the main findings of this study? Athletic individuals revealed a larger aortic diameter compared with sedentary controls. The 99th percentile value for aortic diameter in athletes was defined as the upper limit and was 40mm in males and 38mm in females. The aortic diameter measured >40mm in 5 males (0.17%); (range of 40-43mm) and >38mm in 6 females (0.4%); (range 39-41mm). None of the athletes with an enlarged aortic root diameter fulfilled the clinical features of Marfan syndrome, a condition known to cause aortic enlargement and sudden death. The main determinants of an enlarged aorta were body surface area and the size of the main pumping chamber called the left ventricular cavity, suggesting that large athletes who trained intensively were more likely to have an enlarged aortic diameter compared with smaller athletes who trained less intensively. Whether you were of black or white ethnicity had no significant influence on the size of the aorta. Our study also showed that males and females competing in predominantly endurance
Cardiac Risk in the Young
