University of Connecticut School of Medicine, Department of Medicine, Farmington, CT, USA.
Circulation. 2013 Feb 19;127(7):791-8. doi: 10.1161/CIRCULATIONAHA.112.000974. Epub 2013 Jan 15.
The aorta is exposed to hemodynamic stress during exercise, but whether or not the aorta is larger in athletes is not clear. We performed a systematic literature review and meta-analysis to examine whethere athletes demonstrate increased aortic root dimensions compared with nonathlete controls.
We searched MEDLINE and Scopus from inception through August 12, 2012, for English-language studies reporting the aortic root size in elite athletes. Two investigators independently extracted athlete and study characteristics. A multivariate linear mixed model was used to conduct meta-regression analyses. We identified 71 studies reporting aortic root dimensions in 8564 unique athletes, but only 23 of these studies met our criteria by reporting aortic root dimensions at the aortic valve annulus or sinus of Valsalva in elite athletes (n=5580). Athletes were compared directly with controls (n=727) in 13 studies. On meta-regression, the weighted mean aortic root diameter measured at the sinuses of Valsalva was 3.2 mm (P=0.02) larger in athletes than in the nonathletic controls, whereas aortic root size at the aortic valve annulus was 1.6 mm (P=0.04) greater in athletes than in controls.
Elite athletes have a small but significantly larger aortic root diameter at the sinuses of Valsalva and aortic valve annulus, but this difference is minor and clinically insignificant. Clinicians evaluating athletes should know that marked aortic root dilatation likely represents a pathological process and not a physiological adaptation to exercise.
在运动过程中，主动脉会受到血流动力学的影响，但运动员的主动脉是否更大还不清楚。我们进行了系统的文献回顾和荟萃分析，以研究与非运动员对照组相比，运动员的主动脉根部尺寸是否增大。
我们从 2012 年 8 月 12 日开始在 MEDLINE 和 Scopus 上搜索报告精英运动员主动脉根部大小的英文文献。两位调查员独立提取运动员和研究特征。采用多元线性混合模型进行荟萃回归分析。我们确定了 71 项研究报告了 8564 名独特运动员的主动脉根部尺寸，但只有 23 项研究符合我们的标准，报告了精英运动员的主动脉瓣环或主动脉窦根部尺寸（n=5580）。在 13 项研究中，运动员与对照组（n=727）直接比较。荟萃回归分析显示，在主动脉窦测量的主动脉根部直径平均值在运动员中比在非运动员对照组中大 3.2 毫米（P=0.02），而在主动脉瓣环处的主动脉根部尺寸在运动员中比在对照组中大 1.6 毫米（P=0.04）。
精英运动员的主动脉窦和主动脉瓣环的主动脉根部直径略大，但差异很小，临床上无显著意义。评估运动员的临床医生应该知道，明显的主动脉根部扩张可能代表一种病理性过程，而不是对运动的生理性适应。
